Burden and determinants of chronic kidney disease among diabetic patients in Ethiopia: A systematic Review and Meta-analysis, 2020

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Abstract Background Chronic kidney disease (CKD) among diabetic patients is becoming a global health burden with a high economic cost to health systems. Its incidence is increased at higher rate in low income countries including Ethiopia. In Ethiopia, there is no national representative evidence on burden and determinants of chronic kidney disease among diabetic patients. Therefore, this review aimed to estimates the pooled burden and determinants of chronic kidney disease among diabetic patients. Methods Published articles from various electronic databases such as Pub Med, Google scholar, CINAHL, Scopes, Cochrane library, the Web of Science and African Journals Online were accessed. Also, unpublished studies from Addis Ababa digital library were identified. All observational studies that were conducted on the burden and determinants of chronic kidney disease among diabetic patients were included. Data were extracted on the Microsoft excel spreadsheet and analyzed using STATA 14.1 version. A random-effects model was used to estimate the pooled estimate with a 95% confidence interval (CI). Forest plots were used to visualize the presence of heterogeneity and estimate the pooled burden and determinants of chronic kidney disease among diabetic patients. The presence of publication bias was assessed by funnel plots and Egger’s statistical tests. Results Published (163) and unpublished (2) literature were identified from several databases and digital library, of which ten articles were selected for final meta-analysis. Significant heterogeneity was observed across studies (I 2 = 84.6%), which suggests random-effects model to estimate pooled burden. The analysis found that the pooled burden of chronic kidney disease among diabetic patients was 17.55% (95%CI: 14.23–20.88). Being hypertensive patient, type II DM and staying with DM for greater than 10 years had positive significant association with chronic kidney disease. Conclusion The current review revealed a higher burden of chronic kidney diseases among diabetic patients in Ethiopia. Presence of hypertension, type of diabetes mellitus and staying with diabetes for longer duration were found to be independent determinants of chronic kidney disease among diabetic patients. For better control of chronic kidney disease, integrated management of hypertension and DM should be designed with special focus on chronic diabetic patients.

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