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Prevalence of chronic kidney disease in diabetic adult out-patients in Tanzania

Mubarakali N Janmohamed1*, Samuel E Kalluvya1, Andreas Mueller2, Rodrick Kabangila1, Luke R Smart13, Jennifer A Downs13 and Robert N Peck13

Author affiliations

1 Department of Internal Medicine, Bugando Medical Centre, Mwanza, Tanzania

2 Department of Tropical Medicine, Medical Mission Hospital, Wuerzburg, Germany

3 Center for Global Health, Weill Cornell Medical College, New York, NY, USA

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Citation and License

BMC Nephrology 2013, 14:183  doi:10.1186/1471-2369-14-183

Published: 31 August 2013



The number of adults with diabetes mellitus is increasing worldwide, particularly in Asia and Africa. In sub-Saharan Africa, renal complications of diabetes may go unrecognized due to limited diagnostic resources. The prevalence of chronic kidney disease (CKD) among adult diabetics in sub-Saharan Africa has not been well described.


This study was conducted at the diabetes mellitus clinic of Bugando Medical Centre in Mwanza, Tanzania. A total 369 consecutive adult diabetic patients were enrolled and interviewed. Each patient provided a urine sample for microalbuminuria and proteinuria and a blood sample for serum creatinine level. Estimated glomerular filtration rate (eGFR) was calculated using the Cockroft-Gault equation. CKD was staged according to the Kidney Disease Improving Global Outcomes system.


A total of 309 (83.7%) study participants had CKD; 295 (80.0%) had significant albuminuria and 91 (24.7%) had eGFR < 60 ml/min. None of these patients were aware of their renal disease, and only 5 (1.3%) had a diagnosis of diabetic nephropathy recorded in their file. Older age was significantly associated with CKD in this population [OR 1.03, p = 0.03, 95%CI (1.00-1.05)].


Chronic kidney disease is highly prevalent among adult diabetic outpatients attending our clinic in Tanzania, but is usually undiagnosed. Nearly ¼ of patients had an eGFR low enough to require dose adjustment of diabetic medications. More diagnostic resources are needed for CKD screening among adults in Tanzania in order to slow progression and prevent complications.

Diabetes mellitus; Microalbuminuria; Proteinuria; CKD; Chronic kidney disease; Sub-Saharan Africa