Prevalence and factors associated with metabolic syndrome among adults with stage 3–5 chronic kidney disease attending tertiary hospitals in Dodoma, Tanzania

Metabolic syndrome (MetS) is increasing globally among adults with chronic kidney disease (CKD), and accelerates CKD progression, cardiovascular complications, poor quality of life, increased healthcare costs, and premature mortality. This study determined the prevalence and associated factors with MetS among adults with CKD attending tertiary hospitals in Dodoma. A hospital-based cross-sectional study was conducted among 350 adults with CKD between November 2024 and May 2025 using consecutive sampling. Data were collected through interviews, clinical assessments, and laboratory investigations following standard procedures. MetS was defined using the Adult Treatment Panel III criteria. Data were analyzed using SPSS version 26; and multivariable logistic regression identified associated factors. The prevalence of MetS was 35.4% (124/350). Most affected patients had hypertension (91%), central obesity (87%), impaired fasting glucose (75%), low HDL (68.5%), and elevated triglycerides (64.5%). Factors independently associated with MetS included CKD duration > 60 months, alcohol consumption, physical inactivity, elevated CRP, age ≥ 60 years, advanced CKD (stage 4 and 5), and elevated serum uric acid. MetS is highly prevalent among adults with CKD in this setting and is strongly associated with advanced age, unhealthy lifestyles, prolonged and advanced CKD, inflammation, and hyperuricemia. Routine screening, lifestyle modification interventions, early risk factor management, and integrated care for CKD patients are recommended to reduce cardiovascular risk and disease progression.