Prevalence and associated factors of chronic kidney disease among hypertensive patients attending cardiac clinic at a tertiary hospital in Tanzania: a hospital-based cross-sectional study
Abstract
Abstract Objective To determine the prevalence of chronic kidney disease (CKD) and associated factors among adults with hypertension attending a tertiary cardiac clinic in Tanzania. Design Hospital-based cross-sectional study. Setting Tertiary cardiac outpatient clinic in Dar es Salaam, Tanzania. Participants A total of 162 adults aged ≥18 years with documented hypertension attending follow-up care from 15 June to 30 July 2024 were recruited using simple random sampling. Main outcome measures The primary outcome was study-defined CKD, classified from available records as estimated glomerular filtration rate (eGFR)<60 mL/min/1.73 m² and/or urine dipstick proteinuria ≥1+. Urine albumin-to-creatinine ratio (UACR) and confirmation of persistence for ≥3 months were not available for all participants. Factors associated with CKD were assessed using crude and multivariable logistic regression. Results Among 162 hypertensive patients, 34 met the study-defined CKD criteria, giving a prevalence of 21.0% (95% CI 15.4% to 27.9%). Median serum creatinine was 94 µmol/L (IQR 77–122; range 48–286) and median eGFR was 77 mL/min/1.73 m² (IQR 62–92; range 19–118); 29 (17.9%) participants had eGFR <60 mL/min/1.73 m². Diabetes was independently associated with CKD (adjusted OR 3.257, 95% CI 1.167 to 9.091, p=0.024). Uncontrolled hypertension was not statistically associated with CKD after adjustment (adjusted OR 1.330, 95% CI 0.546 to 3.236, p=0.531); age, sex and education level were also not significant. Conclusions Study-defined CKD was identified in about one-fifth of this tertiary-clinic hypertensive sample, and diabetes was the only independent factor identified. The estimate should be interpreted cautiously because the study was single-centre and full Kidney Disease: Improving Global Outcomes confirmation using chronicity and UACR was not available for all participants. Multicentre studies using repeated eGFR and quantitative albuminuria assessment are needed.