Factors associated with chronic kidney disease stage among patients with uncontrolled diabetes and/or hypertension in Northeastern Thailand: a cross-sectional study

Abstract

Abstract Objective To identify demographic, socioeconomic, behavioural and psychosocial factors associated with chronic kidney disease (CKD) stage among patients with uncontrolled diabetes mellitus and/or hypertension and CKD stages 1–3a. Design Cross-sectional study. Setting Two non-communicable disease clinics in Health Region 10, northeastern Thailand. Participants A total of 385 patients aged 30–70 years with CKD stages 1–3a and uncontrolled diabetes and/or hypertension. Primary outcome measure CKD stage at the time of assessment, obtained from clinical records, was dichotomised as Stage 1 versus Stages 2–3a. Multivariable logistic regression was used to identify factors associated with Stage 1. As this was a cross-sectional study, the outcome represented CKD stage at a single time point rather than CKD progression. Results Participants’ mean age was 59.50 years (SD 8.22), and 70.39% were female. In adjusted analyses, those aged 51–60 years had lower odds of Stage 1 than those aged ≥61 years (AOR=0.52; 95% CI 0.31 to 0.88; p=0.016). Compared with income >20 000 Baht, incomes <5000 Baht (AOR=5.49; 95% CI 1.35 to 22.29; p=0.017) and 10 001–15 000 Baht (AOR=6.94; 95% CI 1.55 to 31.06; p=0.011) were associated with higher odds of Stage 1. Low versus high medication-related self-care was also associated with higher odds of Stage 1 (AOR=2.15; 95% CI 1.30 to 3.56; p=0.003). Conclusions Age, income and medication-related self-care were associated with CKD stage. The unexpected associations of lower income and lower medication-related self-care with Stage 1 should be interpreted cautiously because of the cross-sectional design and potential reverse causation, selection bias and residual confounding. Longitudinal studies are needed to assess changes in kidney function over time.