Progression in adult patients with early-stage chronic kidney disease attending tertiary hospitals in Dodoma, Tanzania: prospective longitudinal study

OBJECTIVE: To determine progression in adult patients with early-stage chronic kidney disease (CKD) attending tertiary hospitals in Dodoma, Tanzania. DESIGN: Prospective longitudinal study. SETTING: This study was conducted in two tertiary hospitals in Dodoma, Tanzania. PARTICIPANTS: and who gave a written informed consent. A total of 352 patients were enrolled, of whom 182 were males and 170 were females. MAIN OUTCOME: The dependent variable in this study was CKD progression, which was assessed after 12 months of follow-up. RESULTS: , urine protein creatinine ratio was 0.099 (0.025-0.158) mg/g, and haemoglobin was 11.7 (9.7-12.6) g/L. Of the patients with CKD progression, 75.3% (73/97) had diabetes mellitus, 72.2% (70/97) of the patients had hypertension, 58.8% (57/97) of the patients had significant proteinuria, and 58.8% (57/97) of the patients had anaemia. Variables associated with CKD progression after multivariate logistic regression analysis were; diabetes mellitus (OR=7.02, 95% CI 3.01 to 16.39, p=0.001), use of local herbs (OR=27.98, 95% CI 11.08 to 70.70, p=0.001), anaemia (OR=2.49, 95% CI 1.32 to 4.68, p=0.005), proteinuria (OR=7.51, 95% CI 3.49 to 16.19 p=0.001). Half, 52.5% (51/97) of the patients with CKD progression were found to have left ventricular hypertrophy (LVH), 26.8% (26/97) of the patients had evidence of coronary artery disease (CAD) on non-invasive testing, and 11.3% (11/97) of the patients died during the study period. CONCLUSION: A substantial portion of adult patients with early-stage CKD were found to have progression after 12 months of follow-up. Diabetes mellitus, proteinuria, anaemia and use of local herbal medicines were significant predictors for CKD progression. Of the patients with CKD progression, more than half of the patients were found to have LVH, almost one third of the patients had evidence of CAD on non-invasive testing, and few patients died.