Prevalence of diabetic kidney disease in Brazil: A systematic review with meta-analysis.

This systematic review assesses the prevalence of diabetes kidney disease (DKD) in Brazil, examining geographical variations and associated risk factors. Following PRISMA guidelines and PROSPERO registration, searches were conducted in PubMed, EMBASE, and LILACS for studies up to and including December 2025. Two researchers independently performed screening, data extraction, and quality assessment. Pooled prevalence was estimated using a random-effects meta-analysis (generalized linear mixed model). Subgroup analyses included diabetes type, duration, diagnostic criteria, healthcare setting, and region. A total of 46 studies were included (n = 24,893 individuals). The pooled prevalence of DKD among Brazilian adults was 27.06% (95% CI 22.40-32.29; I2 98%). Higher prevalence was associated with longer diabetes duration: 33.28% for ≥10 years versus 24.32% for <10 years. Estimates varied by diabetes type: type 1, 28.93% [18.06-42.92] and type 2, 28.61% [20.95-37.73]. Diagnostic criteria significantly influenced results: albuminuria only (32.30%), estimated glomerular filtration rate (eGFR) only (17.70%), and combined eGFR/albuminuria (30.69%). Regional data showed higher prevalence in the South (41.0%), with limited data available for the North and Northeast. High heterogeneity highlights the need for multicenter studies using standardized definitions to improve national surveillance.