Demssie Melese Enyew, Tegegne Awoke Seyoum, Workie Demeke Lakew
Department of Statistics, Woldia University, Weldiya, Ethiopia.
Department of Statistics, Bahir Dar University, Bahir Dar, Ethiopia.
Sci Rep. 2025 Aug 2;15(1):28213. doi: 10.1038/s41598-025-13031-1.
Chronic kidney disease (CKD) is a leading cause of mortality, particularly in developing countries. The main objective of current research was to assess the progress and associated factors among CKD patients under treatment at Felege-Hiwot Referral Hospital and Gambi Teaching Hospitals. A study was conducted on a randomly selected 343 CKD outpatients whose follow ups were from September 2017 to January 2021. A longitudinal data were analyzed using logistic regression and Markov Chain techniques. Among the predictors in the current study, rural patients (AOR = 0.698; 95% CI: (0.551, 0.883) and p-value = 0.003), patients with high urinary protein (AOR = 0.771: 95% CI: (0.609,0.976) and p-value = 0.03, patients with high blood urea nitrogen (AOR = 0.961:95%CI: (0.942,0.980) and p-value < 0.01), patients with high hematocrit (AOR = 1.073:95%CI: (1.052,1.094) and p-value < 0.001) and Visiting time of CKD patients (AOR = 1.041: 95% CI: (1.021, 1.061), p-value < 0.001 and the dependence of the parameter (AOR = 1.733:95% CI: (1.345, 1.986) and p-value < 0.001) significantly affected the status of CKD in the study area. Among the potential predictor variables, Blood urea nitrogen, Urinary protein and Lasix had negatively affected the status of CKD patients to be categorized in normal range, whereas, Visiting time and hematocrit positively affected the progress of status of CKD patients to be categorized in normal range. According to the current study, CKD outpatients in rural areas are less likely to have a normal status. More attention should be given those patients living in rural area, patients with high level of blood urea nitrogen and high amount of urinary protein. Health related education should be given to CKD patients to attend closely and adhere the prescribed medication while patients visits the hospitals for treatment and check ups. More attention is also recommended for those CKD with comorbidities.
慢性肾脏病（CKD）是导致死亡的主要原因，在发展中国家尤其如此。当前研究的主要目的是评估费莱格 - 希沃特转诊医院和甘比教学医院正在接受治疗的CKD患者的病情进展及相关因素。对随机选取的343名CKD门诊患者进行了一项研究，其随访时间为2017年9月至2021年1月。使用逻辑回归和马尔可夫链技术对纵向数据进行了分析。在本研究的预测因素中，农村患者（调整后比值比[AOR]=0.698；95%置信区间：(0.551, 0.883)，p值=0.003）、尿蛋白高的患者（AOR=0.771：95%置信区间：(0.609,0.976)，p值=0.03）、血尿素氮高的患者（AOR=0.961：95%置信区间：(0.942,0.980)，p值<0.01）、血细胞比容高的患者（AOR=1.073：95%置信区间：(1.052,1.094)，p值<0.001）以及CKD患者的就诊时间（AOR=1.041：95%置信区间：(1.021, 1.061)，p值<0.001）和参数的依赖性（AOR=1.733：95%置信区间：(1.345, 1.986)，p值<0.001）显著影响了研究区域内CKD的病情状况。在潜在的预测变量中，血尿素氮、尿蛋白和速尿对CKD患者病情被归类为正常范围产生了负面影响，而就诊时间和血细胞比容对CKD患者病情进展被归类为正常范围产生了积极影响。根据当前研究，农村地区的CKD门诊患者病情处于正常状态的可能性较小。应更加关注那些居住在农村地区、血尿素氮水平高和尿蛋白量高的患者。应该对CKD患者进行健康教育，使其在到医院接受治疗和检查时密切关注并坚持遵医嘱用药。对于那些患有合并症的CKD患者也建议给予更多关注。
