Chronic kidney disease progression rate and predictors in hypertensive patients: A 5-year retrospective follow-up study in Ethiopia

Abstract

INTRODUCTION: Chronic kidney disease is a major public health concern worldwide. Despite the well-established link between hypertension and chronic kidney disease, early detection and management of chronic kidney disease among hypertension patients in primary healthcare settings remain inadequate. Moreover, studies on the progression and predictors of chronic kidney disease among hypertensive individuals in Ethiopia, particularly in the study area, are limited. Therefore, this study aimed to assess chronic kidney disease progression rate, incidence, and predictors among hypertensive patients in South Gondar Zone hospitals in Ethiopia. METHODS: A retrospective follow-up study was conducted among the medical records of 510 hypertensive patients in South Gondar Zone hospitals, North West Ethiopia, from September 2019 to June 2024, which was selected through simple random sampling technique. Data were collected via a structured checklist with an Android-based Kobo collection toolbox from the medical charts. EPI data version 4.2 and STATA version 17 were used for data entry and analysis. Kaplan‒Meier, log-rank tests, and a Cox proportional hazard regression model were used for data analysis. RESULT: Progression to chronic kidney disease occurred at a median of 46 months (IQR:37-55) in hypertension patients. The incidence rate of chronic kidney disease among hypertensive patients was 9.45 (95% CI: 8.07, 11.01) per 1000 person-month observations. Uncontrolled blood pressure (AHR = 1.52, 95% CI: 1.05-2.20), obesity (AHR = 2.56, 95%CI: 1.63-4.01), and high triglyceride levels (AHR = 1.72, 95%CI: 1.03-2.91) were significant predictors of rapid progression of chronic kidney disease among hypertensive patients as compared with their counterparts. CONCLUSION AND RECOMMENDATION: Hypertensive patients in this study progressed to chronic kidney disease more rapidly as compared to other studies. This could be explained by obesity, uncontrolled blood pressure, and high triglyceride levels. Routine screening of triglyceride levels and lifestyle modifications that target obesity reduction and impact blood pressure control is recommended.