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

BMC Nephrology

Robert N Peck³  Jennifer A Downs³  Luke R Smart³  Rodrick Kabangila¹  Andreas Mueller²  Samuel E Kalluvya¹  Mubarakali N Janmohamed¹ 

[1] Department of Internal Medicine, Bugando Medical Centre, Mwanza, Tanzania;Department of Tropical Medicine, Medical Mission Hospital, Wuerzburg, Germany;Center for Global Health, Weill Cornell Medical College, New York, NY, USA

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

Others  :  1082856
DOI  :  10.1186/1471-2369-14-183

 received in 2013-05-13, accepted in 2013-08-29,  发布年份 2013

【 摘 要 】

Background

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.

Methods

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.

Results

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)].

Conclusions

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.

【 授权许可】

   
2013 Janmohamed et al.; licensee BioMed Central Ltd.

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