TUDY TO EVALUATE FACTORS ASSOCIATED WITH RENAL COMPLICATIONS AMONG PATIENTS WITH DIABETES MELLITUS ATTENDING JARAMOGI OGINGA ODINGA TEACHING AND REFERRAL HOSPITAL

Abstract

Diabetes mellitus is a major contributor to renal complications such as Diabetic Nephropathy (DN), chronic kidney disease (CKD) and End-stage renal disease (ESRD) and is an increasing global public health concern. Diabetic patients' morbidity and mortality are significantly influenced by renal complications. However, there is little information available about the occurrence of renal complications in diabetes patients in Kenya, especially at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH), and the factors that are linked to these complications. Developing focused interventions to prevent and manage renal complications in this population requires an understanding of the clinical and sociodemographic factors that drive them. The study's main goals were: To find out how common renal problems are in diabetes mellitus patients who visited JOOTRH, to determine if clinical characteristics (such as glycemic control, hypertension, and the length of diabetes) were associated with renal problems in patients with diabetes who are receiving care at JOOTRH and to ascertain if patients undergoing treatment at JOOTRH's diabetic clinic had a correlation between sociodemographic factors (such as age, gender, and socioeconomic level) and renal complications. The study employed a retrospective study design and was carried out by reviewing existing eligible medical records of diabetic patients who visited and had been on follow up at the JOOTRH medical wards, renal clinic, and diabetic clinic, between 1 st March 2024 and 30th September 2024. Data on patient demographics, clinical characteristics, and renal complications were extracted from qualified patient medical records using a structured data extraction form. Laboratory test results (such as serum creatinine, eGFR, and proteinuria) and clinical diagnoses were used to evaluate and grade renal complications. The researcher utilized descriptive statistics to determine the renal complications' prevalence. Chi-square tests of association was used to examine the relationship between clinical and sociodemographic factors and renal complications; a p value of less than 0.05 was deemed statistically significant. ix The study revealed a renal complication prevalence of 48.7% among the diabetic patients at JOOTRH. It also found that hypertension and poor glycemic control were significantly associated with renal complications among diabetic patients attending JOOTRH. Age was found to be a significant demographic factor, with older patients (60 years and above) exhibiting a higher prevalence of renal complications. Socioeconomic factors also contributed to renal complications, as found by this study. This study identified several factors associated with renal complications among diabetic patients at JOOTRH, notably age, duration of diabetes, hypertension, and poor glycemic control. The findings underscore the urgent need for focused interventions to improve renal health in diabetic patients. The study concludes that: (1) Renal complications are prevalent among diabetic patients at JOOTRH, necessitating routine screening for early identification and intervention. (2) Clinical factors, including hypertension, poor glycemic control, and long diabetes duration, significantly contribute to the development of renal complications and (3) Sociodemographic factors such as age and socioeconomic status influence the risk of renal complications, highlighting the need for targeted public health initiatives.