Chronic Kidney Disease Among Diabetes Mellitus Patients in Southern Ethiopia: Burden, Awareness and Associated Factors - A Mixed Method Study

<i>Background: </i>Ethiopia is one of the developing countries with a high burden of chronic kidney disease (CKD) among diabetes mellitus (DM) patients. However, little is known about its extent, patient awareness level and contributing factors among patients with diabetes. Therefore, this study was aimed to determine the magnitude, awareness and factors associated with CKD among DM patients in Wolaita Sodo, Southern Ethiopia.<i> Methods: </i>An institutional-based cross-sectional study with concurrent qualitative study design was conducted between March 2023 and May 2023 in Wolaita Sodo University Comprehensive Specialized Hospital. A total of 312 patients were selected randomly for quantitative part, and fourteen patients were selected for qualitative study. Data was collected using both medical charts and in-depth interview of patients. Binary logistic regression with odds ratio was used to analyse the association of outcome with predictor variables. P value <0.05 was used to declare statistical significance. Qualitative interview was analysed thematically.<i> Result: </i>The majority 206 (66.03%) of participants were male. The mean age (±SD=standard deviation) of participants was 43 (±13.95) years. The proportion of chronic kidney disease among diabetes patients was 20.05% (95% confidence interval [CI]: 18-29). The duration of diabetes greater than ten years (adjusted odds ration [AOR]= 3.42: 95% CI: 1.58-7.38, p = 0.002), Proteinuria (AOR = 5.13: 95% CI: 2.40-10.96, p < 0.001), diabetic retinopathy (AOR = 2.36: 95% CI: 1.07-5.18, p = 0.032), and fasting blood sugar (FBS) levels of 150 mg/dL or higher (AOR = 2.40: 95% CI: 1.10-5.23, p = 0.026) were independently associated with CKD. Low patient awareness of CKD, poor perception of susceptibility and lack of initiative to know their kidney heath status was the main identified themes qualitatively.<i> Conclusion: </i>High burden with unacceptably low awareness of chronic kidney disease was found in this study. Prolonged duration of diabetes, proteinuria, diabetic retinopathy, and elevated fasting blood sugar levels were significantly associated with chronic kidney disease. Comprehensive patient education, routine screening, and integrated care strategies that not only promote awareness but also address the significant predictors to enhance early detection and prevention of CKD in diabetes patients should be implemented.