Chronic Kidney Disease (CKD) is a major complication of diabetes with a high burden in low-resource settings including Ethiopia due to lack of dialysis, early screening and failure to identify the risk factors for the disease. In Ethiopia, there is a shortage of comprehensive evidence on CKD among diabetic patients. Therefore, this study focused on the gap to addresses CKD in diabetic patients and associated factors in Harari region, eastern Ethiopia. Hospital-based cross-sectional retrospective study was conducted among 315 diabetic patients. Five years data (from January 1, 2019, to December 31, 2024) was collected. Data was collected using Kobo software through chart reviews and checklists in February, 2025, and analyze by SPSS version 25. Descriptive statistics were used to describe frequency, percentage, and tabulation. Bivariable and multivariable logistic regression analyses were conducted to identify associated factors with the outcome variable. Adjusted odds ratio (AOR) with 95% confidence intervals were reported to quantify the strength of associations, and statistical significance was declared at a p-value < 0.05.The study revealed that the prevalence of CKD was (33.2%, 95% CI: 28.5-38.3) among diabetic patients. Alcohol consumption (AOR, 3.89; 95% CI: 1.88-8.03), duration of diabetic (AOR, 3.13; 95% CI: 1.62, 3.77), LDL (AOR, 2.13; 95% CI: 1.21-2.32), prior renal disease (AOR, 4.51; 95% CI: 4.36-5.45), and history of cardiovascular disease (AOR, 2.28; 95% CI: 1.17-4.43) were significantly associated with CKD. However, oral antidiabetic medications has protective effect of CKD (AOR, 0.025; 95% CI: 0.007-0.094). In the study, more than one-third of diabetic patients has developed CKD. Alcohol consumption, LDL, duration of diabetic, prior renal disease, history of cardiovascular disease, and oral therapy were found significantly associated with CKD. A tailored interventions like screening, and awareness creation should be given to diabetic patients to reduce the burden of CKD among diabetic patients.

The authors have declared no competing interest.

The authors were not received any sources of funding for this research work

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Ethical clearance was obtained from the Haramaya University, College of Health and Medical Sciences Institutional Health Research Ethics Review Committee (Ref. No. IHRERC/021/2025) prior to data collection.

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