ZELALEM TOLOSA2026-02-062023-10https://etd.hu.edu.et/handle/123456789/736Background: Chronic kidney disease (CKD) is a serious issue for public health. According to the WHO report for 2022, 17 million people will die from NCD diabetes (2.0 million including kidney disease deaths caused by diabetes) before the age of 70, with low- and middle-income countries providing for 86% of these premature deaths. 77% of NCD-related deaths occur in low- and middle-income countries including Ethiopia. is one of the low- and middle-income nations in the sub-Saharan region. This study was aimed to estimated the effect of covariates on progression between different stages of CKD among patients under follow up treatment at Tikur Anbessa Specialized Hospital TASH, Addis Ababa, Ethiopia, using Multistate Markov Model. Method: The study was carried out using a retrospective cohort study design on 267 CKD patients age greater than 18 randomly selected at nephrology clinic of TASH who start follow up in May 2018 up to April 2023 for five years. The five stages of CKD disease defined based on the Kidney Disease Improving Global Outcome (KDIGO) guidelines with make only forward transition among different transient stage continuously considered in the Multi-state Markov Model to estimate the transition conditional probabilities, transition intensity rate, total length of stay in different CKD patient’s stage. Result: From the total number of patients included in the study (267 CKD patients), 153 (57.3%) were males and 114 (42.7%) were females. Patients in stages 1, 2.3A, 3B, and 4 had an estimated probability of 94% (0.94), 93% (0.93), 93% (0.93), 96% (0.96), and 98% (0.98) of staying in the same stage, respectively, after one month. Estimated sojourn times for states 1, 2, 3A,3B and 4 were 16.5, 14.5, 15.5, 30.3 and 53.8 months respectively. Conclusion: Prognostic factors like being male, having a history of Diabetes, having a history of Hypertension, and having a history of heart disease were the factors that had a higher risk of progressing to severe stages in CKD patients, and Age, Haemoglobin, and Potassium were positively (or harmfully) associated with the progression of eGFR or CKD stages. Whereas Phosphate, Sodium, and Urea were negatively associated with the progression change of eGFR or CKD stages. The transition probability from a given good stage to the next worse stage increases with time, reaches its optimum (peak) at a time, and starts to decline as time goes on. stage 4 CKD had the longest estimated mean duration, followed by stage 3B, while the expected mean duration of stage 2 CKD was the shortest.en-USMulti-State Markov ModelChronic Kidney Disease (CKD)Transition ProbabilityThesis