The Prevalence and Associated Factors of Metabolic Acidosis Among Non-Dialysis Chronic Kidney Disease Patients Attending Outpatient Clinic at Bugando Medical Centre, Mwanza Tanzania.
Material type:
TextPublisher number: Wurzburg Road 35, Premises, Post Code: 33102 | P. O. Box 1464 Mwanza, Tanzania | Phone: (255) 28-298-3384 |Fax: (255) 28-298-3386 |Email: vc@bugando.ac.tz |Website: www.bugando.ac.tz Language: English Language: Kiswahili Publication details: Mwanza, Tanzania | Catholic University of Health and Allied Sciences [CUHAS-Bugando] | 2024. Description: 97 Pages; Includes ReferencesSubject(s): Summary:
Abstract:
Background: Impaired acid base homeostasis is one of the most common complications in patients with Chronic kidney disease (CKD) which result in acid retention, decrease in serum bicarbonate and overall causing metabolic acidosis (MA), it usually occurs with eGFR <60 ml/min/1.73m2. Metabolic acidosis in CKD is linked with Mineral Bone Disease (MBD), exacerbating muscle catabolism, CKD progression and increase mortality. In Tanzania there is paucity of data on the burden of metabolic acidosis and its associated factors among patients with CKD.
Objective: To determine the prevalence and associated factors of metabolic acidosis among nondialysis chronic kidney disease patients attending outpatient clinic at Bugando medical centre.
Methods: Hospital based cross-sectional study design which was conducted at Bugando Medical Centre between December 2023 to April 2024. Structured questionnaire where used to obtain social demographic and clinical information. Blood samples were collected for assessment of CKD, MA and associated factors. CKD and MA were defined as per KDIGO guidelines. For identification of factors associated with metabolic acidosis since the outcome variable was common with a proportion of > 10%, modified Poisson regression was used. All covariates with a p-value of < 0.2 in bivariable analysis were included in the multivariable analysis model.
Results: Among 362 patients with median age of 61 years, male being 59.4% of the total population. The prevalence of MA was 58.0% among patients with CKD not on RRT. The prevalence was increasing with stage of CKD were by stage 3a, 3b, 4 and 5 had 11.4%, 45.5%, 77.5%, 91.3% respectively. Factors associated with MA include Stages of CKD, hyperphosphatemia, hyperkalemia and Proteinuria. MA was 34% more prevalent among those with hyperphosphatemia, 48% more prevalent among those with hyperkalemia and 76% more
prevalent among those with proteinuria >1+ compare to those with normal phosphate, potassium and proteinuria ≤1+ respectively. For stages of CKD, those with stage 3b,4 and 5 were more prevalent to have MA compare to those with 3a.
Conclusion: Our finding shows high prevalence of MA in CKD patients not on dialysis attending outpatient clinic at BMC, in which about two-third of CKD patient had MA. For those with stage 5, nine out of ten had MA. Therefore, routine determination of MA in non-dialysis CKD patients might help in identifying patients that would benefit from bicarbonate supplementation.
Keywords: Metabolic acidosis, Chronic kidney disease.
| Item type | Current library | Status | Barcode | |
|---|---|---|---|---|
| POSTGRADUATE DISSERTATIONS | MWALIMU NYERERE LEARNING RESOURCES CENTRE-CUHAS BUGANDO | Not for loan | 20241016080015.0 |
Abstract:
Background: Impaired acid base homeostasis is one of the most common complications in patients with Chronic kidney disease (CKD) which result in acid retention, decrease in serum bicarbonate and overall causing metabolic acidosis (MA), it usually occurs with eGFR <60 ml/min/1.73m2. Metabolic acidosis in CKD is linked with Mineral Bone Disease (MBD), exacerbating muscle catabolism, CKD progression and increase mortality. In Tanzania there is paucity of data on the burden of metabolic acidosis and its associated factors among patients with CKD.
Objective: To determine the prevalence and associated factors of metabolic acidosis among nondialysis chronic kidney disease patients attending outpatient clinic at Bugando medical centre.
Methods: Hospital based cross-sectional study design which was conducted at Bugando Medical Centre between December 2023 to April 2024. Structured questionnaire where used to obtain social demographic and clinical information. Blood samples were collected for assessment of CKD, MA and associated factors. CKD and MA were defined as per KDIGO guidelines. For identification of factors associated with metabolic acidosis since the outcome variable was common with a proportion of > 10%, modified Poisson regression was used. All covariates with a p-value of < 0.2 in bivariable analysis were included in the multivariable analysis model.
Results: Among 362 patients with median age of 61 years, male being 59.4% of the total population. The prevalence of MA was 58.0% among patients with CKD not on RRT. The prevalence was increasing with stage of CKD were by stage 3a, 3b, 4 and 5 had 11.4%, 45.5%, 77.5%, 91.3% respectively. Factors associated with MA include Stages of CKD, hyperphosphatemia, hyperkalemia and Proteinuria. MA was 34% more prevalent among those with hyperphosphatemia, 48% more prevalent among those with hyperkalemia and 76% more
prevalent among those with proteinuria >1+ compare to those with normal phosphate, potassium and proteinuria ≤1+ respectively. For stages of CKD, those with stage 3b,4 and 5 were more prevalent to have MA compare to those with 3a.
Conclusion: Our finding shows high prevalence of MA in CKD patients not on dialysis attending outpatient clinic at BMC, in which about two-third of CKD patient had MA. For those with stage 5, nine out of ten had MA. Therefore, routine determination of MA in non-dialysis CKD patients might help in identifying patients that would benefit from bicarbonate supplementation.
Keywords: Metabolic acidosis, Chronic kidney disease.
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