{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T14:18:26Z","timestamp":1783520306558,"version":"3.55.0"},"reference-count":49,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"unspecified","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Tanzanian government through the Ministry of Health","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,1]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess factors associated with chronic kidney disease (CKD) awareness and preventive self-care among people living with diabetes at a national tertiary hospital in Tanzania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Hospital-based cross-sectional analytical study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study was conducted at the diabetic clinic of Muhimbili National Hospital in Tanzania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 271 patients attending the diabetic clinic were enrolled.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measures<\/jats:title>\n                    <jats:p>Primary outcomes were awareness and preventive self-care regarding CKD among patients. Median scores were used to categorise awareness as either higher or lower and preventive self-care practices as either better or poorer. Factors associated with awareness and preventive self-care were analysed using logistic regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected using a structured questionnaire capturing sociodemographic characteristics, CKD awareness and CKD preventive self-care practices. Bivariate and multivariable logistic regression analyses were performed to identify independent predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among respondents, 114 (42.1%) had higher CKD awareness while 141 (52.0%) demonstrated better CKD preventive self-care practices. Younger age (&lt;40 years; adjusted OR (AOR): 0.40; 95% CI 0.203 to 0.801; p=0.009), lower education level (AOR: 0.48; 95% CI 0.289 to 0.807; p=0.005) and rural residency (AOR: 0.52; 95% CI 0.300 to 0.917; p=0.024) were independently associated with lower CKD awareness. Conversely, respondents with fewer years of living with diabetes (&lt;5 years; AOR: 2.05; 95% CI 1.173 to 3.592; p=0.012) and those with a family history of diabetes (AOR: 1.84; 95% CI 1.082 to 3.127; p=0.024) were more likely to have poorer CKD preventive self-care practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study found low awareness and suboptimal CKD self-care among people living with diabetes. Awareness was associated with age, education level and residence, while self-care was associated with diabetes duration and family history. These findings highlight the need for early, structured education addressing CKD risk, misconceptions and culturally appropriate behaviour-change strategies to improve adherence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-121713","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T13:30:35Z","timestamp":1783517435000},"page":"e121713","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with chronic kidney disease awareness and preventive self-care practices among patients with diabetes: a cross-sectional study at Muhimbili National Hospital, Tanzania"],"prefix":"10.1136","volume":"16","author":[{"given":"Upendo Anania","family":"Mwansile","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Muhimbili National Hospital, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0428-0161","authenticated-orcid":false,"given":"Gift","family":"Lukumay","sequence":"additional","affiliation":[{"name":"Clinical Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2618-4410","authenticated-orcid":false,"given":"Joel Seme","family":"Ambikile","sequence":"additional","affiliation":[{"name":"Clinical Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"2026070806302058000_16.7.e121713.1","doi-asserted-by":"crossref","unstructured":"Coates PT , Devuyst O , Wong G , et al . 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