Time to diabetic nephropathy and its predictors among adult diabetic patients at public general and referral hospitals in South Wollo Zone, Northeast Ethiopia: A retrospective follow up study.

Abstract

Introduction: The prevalence of diabetes mellitus and its micro vascular and macro vascular complications have been increasing among diabetic patients in Ethiopia. Diabetic nephropathy (DN) is one of the most serious complication of diabetes which leads to end-stage renal disease and other complication of diabetes mellitus. A small number of investigations were carried out in Ethiopia, and the incidence of DN was the main source of data for these studies. Therefore, this study was aimed to estimate time to diabetic nephropathy and its predictors among adult diabetes mellitus patients at public general and referral hospital of South Wollo Zone, Amhara National Regional State, Northeast Ethiopia.

Methods: Retrospective follow up study was conducted among 408 adult diabetes mellitus patients who were on follow up at public general and referral hospital of South Wollo zone from December 10, 2012 to December 9, 2022. Data were entered into Epidata version 4.6, and then exported to Stata version 14 for further statistical analysis. Kaplan Meier survival curve was used to estimate the cumulative survival time and Log rank test was used to compare the survival time between different categories of the predictor variables. Multivariable Cox proportional hazards model was fitted to identify predictors of time to diabetic nephropathy.

Result: Overall, 71 (17.4%) of the study participants developed diabetic nephropathy with incidence density of 2.35/1000 person-months (95% CI; 1.86, 2.97) and Median survival time of this study was 98 [95% CI: 95 -105] months. Sex [AHR: 0.293, 95%CI: 0.154, 0.555], hypertension [AHR: 1.81, 95% CI: 1.01, 3.24], HbA1C [AHR: 1.93, 95% CI: 1.069, 3.49] and HDL [AHR: 0.399, 95% CI: 0.225, 0.708] were predictors of time to diabetic nephropathy.

Conclusion and recommendation: The median survival time of this study was 98 [95% CI: 95 -105] months which was relatively long time compared with previous study. Sex, hypertension, HbA1c and HDL were predictors of time to diabetic nephropathy.