Chronic Kidney Disease-Epidemiology Collaboration (CKD - EPI) classification of kidney function and predictors of kidney dysfunction among type 2 diabetes mellitus patients in a tertiary hospital in Ghana.

Abstract

Introduction: Type 2 Diabetes Mellitus (T2DM) is a major global health concern frequently associated with Kidney Dysfunction (KD). Globally, approximately one in eleven adults have diabetes mellitus, with 90% of these cases being type 2 diabetes mellitus. About two-thirds of T2DM patients experience KD, which may progress to chronic kidney disease and end-stage renal disease. In Ghana, the burden of T2DM is substantial and continues to rise, with kidney failure accounting for approximately 10% of all deaths among individuals with T2DM. This study sought to investigate the predictors of KD among T2DM patients in Ghana and approximately 10% of deaths in people with T2DM are attributable to kidney failure.

Methods: a hospital-based retrospective study design was employed. It involved the medical records of 141 T2DM patients. The data extracted was entered into Microsoft Excel version 16.0 and analyzed using STATA version 16.0. Chi-square test was used to establish associations between categorical variables and KD. Independent t-test was employed to analyze associations between parametric (normally distributed) variables and KD, while the Mann-Whitney U test was used for non-parametric (not normally distributed) variables. The strengths of the identified associations were evaluated using binary logistic regression analysis, with the results reported as odds ratios (OR) along with their 95% confidence intervals.

Results: among the 141 patients, 99 (70.2%) had KD. Formal employment was associated with a 95% reduced odds of kidney dysfunction (aOR = 0.05 (95%CI: 0.004-0.645); p-value = 0.021), while every unit increase in creatinine level was linked to a 10% increased odds of KD (aOR = 1.10 (95%CI: 1.06-1.14); p-value = <0.001).

Conclusion: the study revealed a significant proportion of T2DM patients experiencing kidney dysfunction. Crucially, both occupation and creatinine levels were found to be independent predictors of diabetic KD. This highlights an urgent need to educate T2DM patients, particularly those who are unemployed or informally employed, about preventive measures and the importance of regular monitoring of creatinine levels to safeguard kidney health. This emphasis is vital, as managing kidney disease in the region is notably costly, making early intervention and education key strategies in reducing the burden of KD among T2DM patients.