Prevalence and risk factors of chronic kidney disease in Palestinian patients with diabetes: a cross-sectional study

Chronic kidney disease (CKD) is a worldwide public health problem because of high morbidity and mortality and high costs of treatment. Diabetes is a major risk factor for development and progression of CKD. In this study, we aimed to assess the prevalence of CKD among patients with type 2 diabetes treated in primary health care (PHC) centres in the north area of West Bank, occupied Palestinian territory. A cross-sectional study design was used. A sample size of 385 patients was calculated based on following sample size formula n=Z2 × P × (1 – P)/d2, where p is the expected CKD prevalence and d is the margin of error. All patients with diabetes are referred to their district's PHC clinics for follow-up and management, with 25·35 patients being seen per day. Patients eligible for this study had type 2 diabetes, were 18 years or older. Those with type 1 diabetes or gestational diabetes, women who were pregnant, and those who did not have at least two creatinine measurements at least 3 months apart were excluded from the study. Patients were recruited at random. Between September and December, 2018, every third patient on a given day's client list was chosen. Data were obtained from personal interviews with patients and from their electronic health records Collected data included patients’ characteristics, creatinine levels, blood pressure, glycated haemoglobin A1c (HbA1c), and duration of hypertension and diabetes. Estimated glomerular filtration rate was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. CKD was staged according to the Kidney Disease Improving Global Outcomes System 2012 guidelines. We did univariate and multivariate analyses in SPSS version 20. The threshold for significance was p