| dc.description.abstract | Background: Suboptimal blood pressure control is an important cause of the cardiovascular disease (CVD) and end-stage kidney disease (ESKD) among diabetic patients with kidney disease. The prevalence of ESKD is increasing among diabetic patients with kidney disease among low-income countries despite the existence of blood pressure control interventions. However, the burden of suboptimal blood pressure control and its associated factors among the diabetic population with kidney disease in Uganda are not well documented. Objectives: This study aimed to determine the prevalence of suboptimal blood pressure control and associated factors among ambulatory diabetic patients with kidney disease attending Kiruddu National Referral Hospital (KNRH). Methods: We carried out a cross-sectional study among 625 participants with DM who attended the outpatient clinic of KNRH from 6th May 2020 to 15th July 2020. They were screened for kidney disease with a urine dipstick until the sample size of 250 was obtained. We administered a pretested questionnaire, measured blood pressure, height and weight. We reviewed their files to extract measurements of HbA1c, serum creatinine and low-density lipoprotein (LDL) cholesterol done in the preceding 3 months. The data were analyzed using STATA version 14. The prevalence (95% confidence interval) of suboptimal blood pressure control was determined as a proportion of participants with suboptimal blood pressure control out of the total number of participants in the study. A Poisson regression model was used to analyze the factors associated with suboptimal blood pressure control. Results: The prevalence of suboptimal blood pressure control among diabetic participants with kidney disease was 84.4% (95% CI: 79.3 - 88.4). Suboptimal blood pressure control; was more frequent among participants with past (PR = 1.37, 95% CI: 1.01 - 1.85, p = 0.04) and current (PR = 1.57, 95% CI: 1.23 - 2, p<0.001) alcohol use and among overweight (PR = 1.82, 95% CI: 1.4 - 2.38, p<0.001) and obese (PR = 1.89, 95% CI: 1.44 - 2.47, p<0.001) participants. Suboptimal blood pressure control was less frequent among participants who were wage earners (PR = 0.68, 95% CI: 0.58 - 0.81, p<0.001) and professionals (PR = 0.37, 95% CI: 0.14 - 0.99, p = 0.048). Conclusion: The prevalence of suboptimal blood pressure control among ambulatory diabetic participants with kidney disease was high. Suboptimal blood pressure control was more frequent among those who were overweight, obese and had a history of alcohol use. Participants who were wage earners and professionals were less likely to have suboptimal blood pressure control. Thus, there is a need to institute better blood pressure control strategies among diabetic patients with kidney disease, especially among the identified more-at-risk patient population to improve their outcomes. | en_US |
