P-450: Analysis of ckd trends and factors in type 1 diabetics in Kericho county referral hospital, Kenya, 2025
S KemboiAbstract
Introduction
Type 1 diabetes mellitus (T1D) is a rising global concern, with CKD as a major complication. In 2021, CKD-T1D caused 94,020 deaths and 3.87 million DALYs worldwide, with rising incidence and prevalence since 1990. Sub-Saharan Africa faces a heavy burden: 36% of T1D patients have HbA1c >12.5%, with microvascular issues in 6.2 years. In Kenya, T1D retinopathy is 21.5%, neuropathy 29.4%; CKD >20% in diabetics.
Objectives
To analyze trends in chronic kidney disease (CKD) and associated factors in Type 1 Diabetics attending Kericho County Referral Hospital
Methods
A cross-sectional analysis at Kericho County Referral Hospital involved 150 T1D patients. It assessed albuminuria status, insulin regimen use, glycemic control (HbA1c), and blood pressure (BP). The study reviewed primary healthcare (PHC) utilization, including annual urinary albumin screening and BP monitoring rates.
Results
Among the 150 T1D patients, 48% had normoalbuminuria, 34% microalbuminuria, and 18% macroalbuminuria. Although 72% were on basal-bolus insulin, no insulin regimen was significantly associated with nephropathy. However, HbA1c >7.5% was linked to a 2.3-fold increased risk of albuminuria, and systolic BP >130 mmHg raised the likelihood of microalbuminuria by 1.8-fold. PHC gaps were identified; only 33% received annual urinary albumin screening, and 41% lacked regular BP monitoring. In SSA, systemic challenges such as insulin shortages, limited glucose monitoring, and delayed nephropathy detection further exacerbate CKD-T1D risks
Conclusions
Glycemic control and hypertension management are stronger predictors of CKD, considering insulin regimens in resource-limited settings. Strengthening PHC integration, with regular HbA1c/albuminuria testing, standardized CKD screening, improved access to monitoring tools, context- specific HbA1c targets, patient education, subsidized insulin, and multisectoral strategies, is essential to mitigate the rising CKD-T1D burden in sub-Saharan Africa.