Key result
Low medication-related self-care linked to ~2.1-fold higher odds of Stage 1 vs Stages 2-3a CKD.
Why the study?
Factors associated with CKD stage among patients with uncontrolled diabetes and/or hypertension in northeastern Thailand were not well identified.
Cross-Sectional (n=385)
Yes
Odds Ratio: 2.15 (95% CI 1.3–3.56)
p-value: p=0.003
Among patients with early-stage chronic kidney disease and uncontrolled diabetes or hypertension, age, income, and medication-related self-care are associated with CKD stage, though cross-sectional limitations necessitate longitudinal follow-up to understand causal trajectories.
Low self-care unexpectedly tied to Stage 1 CKD in uncontrolled DM/HTN; hypothesis-generating and should not yet change practice.
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.
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Thachai et al. (2026) conducted a cross-sectional in Chronic Kidney Disease (Stages 1-3a) with uncontrolled diabetes and/or hypertension (n=385). Low medication-related self-care vs. High medication-related self-care was evaluated on CKD Stage 1 (versus Stages 2-3a) (AOR 2.15, 95% CI 1.30 to 3.56, p=0.003). Low medication-related self-care was unexpectedly associated with higher odds of being in CKD Stage 1 versus Stages 2-3a (AOR 2.15) among patients with uncontrolled diabetes and/or hypertension.
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