Volume 96, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



There is limited information on the burden of diabetic nephropathy in developing countries. This study aimed to determine the prevalence of and factors associated with nephropathy among diabetic patients attending an outpatient clinic in Harare, Zimbabwe. In an analytical cross-sectional study, diabetic patients were consecutively enrolled and a questionnaire administered, clinical assessment conducted, and blood samples collected for human immunodeficiency virus testing and measurement of lipids, creatinine, fructosamine, and glycosylated hemoglobin levels. Urine samples were collected for determination of albumin and creatinine levels, which were used to categorize albuminuria. A total of 344 diabetic patients were enrolled. Overall, just over a third (35.8%) of patients had moderately increased albuminuria and 9.0% had severely increased albuminuria giving an overall prevalence of nephropathy of 44.8%. Prevalence of moderately increased albuminuria was slightly higher (36.5% versus 33.3%) and severely increased albuminuria slightly lower (8.8% versus 9.5%) in type 2 than type 1 diabetes patients, but the difference was not statistically significant ( = 0.866). Higher fructosamine and retinopathy were associated with nephropathy in both univariate and multivariate analysis {higher fructosamine (odds ratio [OR] = 1.00, confidence interval [CI] = 1.00–1.01), and retinopathy (OR = 2.80, CI = 1.64–4.97)}. We report a higher prevalence of moderately increased albuminuria and a lower prevalence of severely increased albuminuria compared with findings reported a decade ago among type 1 and type 2 diabetes mellitus patients attending the same clinic. High fructosamine and retinopathy were independent predictors of nephropathy.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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  1. Bouaziz A, Zidi I, Zidi N, Mnif W, Zinelabidine HT, , 2012. Nephropathy following type 2 diabetes mellitus in Tunisian population. West Indian Med J 61: 881889.[Crossref] [Google Scholar]
  2. Zelmanovitz T, Gerchman F, Balthazar AP, Thomazelli FC, Matos JD, Canani LH, , 2009. Diabetic nephropathy. Diabetol Metab Syndr 1: 10.[Crossref] [Google Scholar]
  3. Eknoyan G, Lameire N, Eckardt KU, Kasiske BL, Wheeler DC, Levin A, Stevens PE, Bilous RW, Lamb EJ, Coresh J, , 2013. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int 3: 514.[Crossref] [Google Scholar]
  4. Tesfaye S, Gill G, , 2011. Chronic diabetic complications in Africa. Afr J Diabetes Med 19: 48. [Google Scholar]
  5. El-Minshawy O, , 2011. End stage renal disease in El-Minia Governorate, Egypt: data of the year 2007. Hypertension 200: 24. [Google Scholar]
  6. Afolabi MO, Abioye-Kuteyi EA, Arogundade FA, Bello IS, , 2009. Prevalence of chronic kidney disease in a Nigerian family practice population. S Afr Fam Pract 51: 132137.[Crossref] [Google Scholar]
  7. Janmohamed MN, Kalluvya SE, Mueller A, Kabalinga R, Smart LR, Downs JA, Peck RN, , 2013. Prevalence of chronic kidney disease in diabetic adult out-patients in Tanzania. BMC Nephrol 14: 183.[Crossref] [Google Scholar]
  8. Mafundikwa A, Ndhlovu CE, Gomo ZARG, , 2007. The prevalence of diabetic nephropathy in adult patients with insulin dependent diabetes mellitus attending Parirenyatwa Diabetic Clinic Harare. Cent Afr J Med 53: 16. [Google Scholar]
  9. The Royal College of Ophthalmologists, 2012. Diabetic Retinopathy Guidelines December 2012. London: The Royal College of Ophthalmologists. [Google Scholar]
  10. Tanuja A, Guruprasad BS, Prashanth K, Prasad I, , 2015. Prevalence and risk factors of diabetic retinopathy in a rural population of South India. Int J Diabetes Dev Ctries 35: 356361.[Crossref] [Google Scholar]
  11. Ministry of Health and Child Welfare Republic of Zimbabwe, 2011. 6th Essential Medicines List and Standard Treatment Guidelines for Zimbabwe. Zimbabwe, Harare: The National Medicine and Therapeutics Policy Advisory Committee, Ministry of Health and Child Welfare. [Google Scholar]
  12. O'Connor AS, Schelling JR, , 2005. Diabetes and the kidney. Am J Kidney Dis 46: 766773.[Crossref] [Google Scholar]
  13. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr Jones DW, Materson BJ, Oparil S, Wright JT, Jr Roccella EJ, Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, National Heart, Lung and Blood Institute; National High Blood Pressure Education Program Coordinating Committee; , 2003. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 42: 12061252.[Crossref] [Google Scholar]
  14. James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmerlfarb C, Handler J, Lackland DT, LeFevre ML, Mackenzie TD, Ogedegbe O, Smith SC, Jr Sveetkey LP, Taler SJ, Townsend RR, Wright JT, Jr Ortiz E, , 2014. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 311: 507520.[Crossref] [Google Scholar]
  15. World Health Organization, 1999. Definition, Diagnosis and Classification of Diabetes Mellitus and Its Complications. Geneva, Switzerland: World Health Organization. [Google Scholar]
  16. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), 2002. Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 106: 31433421. [Google Scholar]
  17. Solimani A, Momtaz M, Shaheen N, , 2012. Emergence and progression of albuminuria in a cohort of Egyptian patients with type 2 diabetes mellitus: a 5-year prospective study. Arab J Nephrol Transplant 3: 2328. [Google Scholar]
  18. Lutale JJ, Thordarson H, Abbas ZG, Vetvik K, , 2007. Microalbuminuria among type 1 and type 2 diabetic patients of African origin in Dar es Salaam, Tanzania. BMC Nephrol 8: 2.[Crossref] [Google Scholar]
  19. Bermúdez RM, García SG, Surribas DP, Castelao AM, Sanjuán JB, , 2011. Consensus document. Recommendations on assessing proteinuria during the diagnosis and follow-up of chronic kidney disease. Nefrologia 31: 331345. [Google Scholar]
  20. Madala ND, Thusi GP, Assounga AGH, Naicker S, , 2014. Characteristics of South African patients presenting with kidney disease in rural KwaZulu-Natal: a cross sectional study. BMC Nephrol 15: 61.[Crossref] [Google Scholar]
  21. Cohen DB, Allain JJ, Glover S, Chimbayo D, Damalala H, Hofland HWC, Banda NPK, Zijlstra EE, , 2010. A Survey of the management, control, and complications of diabetes mellitus in patients attending a diabetes clinic in Blantyre, Malawi, an area of high HIV prevalence. Am J Trop Med Hyg 83: 575581.[Crossref] [Google Scholar]
  22. Selvin E, Francis LMA, Ballantyne CM, Hoogeveen RC, Coresh J, Brancati FL, Steffes MW, , 2011. Nontraditional markers of glycemia: associations with microvascular conditions. Diabetes Care 34: 960967.[Crossref] [Google Scholar]
  23. Glover SJ, Burgess PI, Cohen DB, Harding SP, Hofland HWC, Zijlstra EE, Allain TJ, , 2012. Prevalence of diabetic retinopathy, cataract and visual impairment in patients with diabetes in sub-Saharan Africa. Br J Ophthalmol 96: 156161.[Crossref] [Google Scholar]
  24. Onen CL, , 2013. Epidemiology of ischaemic heart disease in sub-Saharan Africa : review article. Cardiovasc J Afr 24: 3442.[Crossref] [Google Scholar]
  25. Sowers JR, Epstein M, Frohlich ED, , 2001. Diabetes, hypertension, and cardiovascular disease an update. Hypertension 37: 10531059.[Crossref] [Google Scholar]
  26. Chinenye S, Uloko AE, Ogbera AO, Ofoegbu EN, Fasanmade OA, Fasanmade AA, Ogbu OO, , 2012. Profile of Nigerians with diabetes mellitus—Diabcare Nigeria study group (2008): results of a multicenter study. Indian J Endocrinol Metab 16: 558.[Crossref] [Google Scholar]
  27. Ogbera AO, Fasanmade OA, Chinenye S, Akinlade A, , 2009. Characterization of lipid parameters in diabetes mellitus: a Nigerian report. Int Arch Med 2: 19.[Crossref] [Google Scholar]
  28. Jahangiri-Noudeh Y, Akbarpour S, Lotfaliany M, Zafari N, Khalili D, Tohidi M, Mansournia MA, Azizi F, Hadaegh F, , 2014. Trends in cardiovascular disease risk factors in people with and without diabetes mellitus: a middle eastern cohort study. PLoS One 9: e112639.[Crossref] [Google Scholar]

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  • Received : 16 Nov 2015
  • Accepted : 31 Aug 2016
  • Published online : 08 Feb 2017

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