Prevalence and associated factors of chronic kidney disease among adults with type 2 diabetes mellitus in Sub-Saharan Africa: A systematic review and meta-analysis

Abstract Introduction Chronic kidney disease (CKD) in adult patients with type 2 diabetus mellitus (T2DM) is a serious public health challenge and continues to be a major source of morbidity and mortality in Sub-Saharan Africa (SSA). The burden of CKD among T2DM patients in SSA has been documented in several studies, but the results remain heterogeneous, and there is limited comprehensive data on its overall prevalence and factors associated with the diseases. Therefore, this study aimed to estimate the pooled prevalence of CKD and assess its associated factors among adult patients with T2DM in SSA. Methods This systematic review and meta-analysis was conducted and reported according to PRISMA 2020 guidelines, and the study protocol was registered in PROSPERO (CRD420261411707). A comprehensive search of relevant studies was conducted from PubMed, Google Scholar, Scopus, Cochrane Library, and EMBASE published between January 2000 and December 2025 in SSA. Data were analyzed using Stata version 17. A random-effects model was used to estimate the pooled prevalence of CKD among adults with T2DM patients. Heterogeneity was assessed using Cochranes Q and I{superscript 2} statistics with visual inspection through forest and Galbraith plots. Publication bias was evaluated using a funnel plot and Eggers test. Subgroup and sensitivity analyses were also performed. Results Out of the 3702 study participants from 16 included studies, the estimated pooled prevalence of CKD among adult T2DM patients in SSA was 35.8% (95% CI: 27.1-44.4), indicating significant heterogeneity (I{superscript 2}=97.25%, p<0.001) across the studies. Subgroup analyses on the pooled prevalence of CKD on the basis of different diagnostic criteria were conducted. Modification of diet in renal disease (MDRD) reported a prevalence of 34% (26, 43), the chronic kidney diseases epidemiology collaboration (CKD-EPI) reported a prevalence of 39% (21, 57), and the Cockcroft-Gault (CG) method reported a prevalence of 34% (12, 56). In addition, older age (OR = 2.27, 95% CI: 1.19-4.33) and longer diabetes duration (OR = 1.90, 95% CI: 1.07-3.40) were factors significantly associated with the prevalence of CKD. Conclusion The prevalence of CKD in SSA was high, affecting nearly one in three adults with T2DM patients. In addition, factors such as older age and longer diabetes duration significantly contributed to the association with CKD. To lessen this issue, focused public health actions are strongly advised, such as screening, education, and awareness campaigns. Systematic review registrations PROSPERO (2026: CRD420261411707).