Predictors of Glomerular Filtration Rate and Time to Develop End-stage for  Chronic Kidney Disease: A Joint Modeling Approach

Enyew, Melese

dc.contributor.author	Enyew, Melese
dc.date.accessioned	2021-08-17T06:05:31Z
dc.date.available	2021-08-17T06:05:31Z
dc.date.issued	2021-08-16
dc.identifier.uri	http://ir.bdu.edu.et/handle/123456789/12445
dc.description.abstract	Background: Chronic Kidney Disease is the most killer and ignored disease, and there are several patients in our country Ethiopia. And the severity of this disease is measured by glomerular filtration rate (GFR), and categorized into three called status namely improved status (GFR of more than 60) and unimproved status (GFR of between 60 and 15), and kidney failure (GFR of less than 15). Nevertheless, few studies were conducted before by considering these categories of GFR. The main objective of this study is to analyze the joint modeling of the longitudinal outcome of patient's status and survival time up to the End Stage Renal Disease. Method: A retrospective cohort study was conducted with 343 CKD patients seen at outpatient department in Felege Hiwot Comprehensive Specialized Referral Hospital and Gamby Teaching Hospital, who had at least two, at most ten visits before the event outcome was occurred, and also age more than two years old at the baseline of the study. Therefore, joint model analysis was analyzed which consists of a mixed effect longitudinal binary sub-model for the repeated status of Chronic Kidney Disease patients and cox proportional hazards sub-model for time to the complication of ESRD using R software. Result: Compared to full age spectrum GFR equation CKD-EPI had relatively similar results as the hospitals identification of ESRD. Joint modeling analysis had smaller error of estimate, smaller residual variability, and significant association parameter (-0.0059, p-value < 0.0001) implies that good model for estimating parameters for each of the two models than using separate models. Urea protein, nifedipine, and hematocrit were the significant predictors in both survival and longitudinal model. Conclusion: The Chronic Kidney Disease Epidemiological Collaboration was relatively good measure for measuring GFR than Full Age Spectrum estimated GFR for the study area. The increase in Urea protein and Hematocrit were the indication for less likely to have improved statuses of patients and more likely for the complication of ESRD. The patients with improved status of CKD patents were fewer hazards for the complication to ESRD. Diabetic mellitus type one patients were less likely to have improved GFR. Health professionals and the concerned bodies should give more attention for identifying the status renal patients.	en_US
dc.language.iso	en_US	en_US
dc.subject	Statistics	en_US
dc.title	Predictors of Glomerular Filtration Rate and Time to Develop End-stage for Chronic Kidney Disease: A Joint Modeling Approach	en_US
dc.type	Thesis	en_US