Date of Conferral



Doctor of Public Health (DrPH)


Public Health


Nancy Rea


Chronic kidney disease (CKD) is a set of pathophysiological reactions that impact the functionality of the kidney. The association between microvascular disease (MVD) and CKD as it relates to diabetes is important to the evaluation of organizational effectiveness in-hospital services planning as well as improving health outcomes. The purpose of this quantitative, cross-sectional study was to determine if there is an association between MVD and CKD severity in persons with diabetes. Using the socioecological model, the association between gender, age group, cigarette smoke, cigarette smoke frequency, alcoholic drink, alcoholic drink frequency, hypertension, albumin-to-creatinine ratio (ACR) severity, cholesterol, sickling (i.e. persons with sickle cell disease), and MVD was examined. Across-sectional data analysis, using secondary data from 2013 to 2017 (N = 775) in the Grenada medical records department, was used to identify associations of CKD status in persons with diabetes over the age of 16 years old. The relationship between the study predictors and the outcome variable was analyzed using chi-square tests and binomial logistic regression. The key findings showed drinking and hypertension were the only significant predictors of CKD severity. The social change implications of this study will not only benefit health care professionals but also the community by assisting in the enhancement of national guidelines and public health policy, and the implementation of programs aimed to improve risk factors that have been shown to reduce CKD outcomes in Grenada.