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The burden of kidney disease in many African countries is unknown. Equations used to estimate kidney function from serum creatinine have limited regional validation. We sought to determine the most accurate way to measure kidney function and thus estimate the prevalence of impaired kidney function in African populations.We measured serum creatinine, cystatin C, and glomerular filtration rate (GFR) using the slope-intercept method for iohexol plasma clearance (mGFR) in population cohorts from Malawi, Uganda, and South Africa. We compared performance of creatinine and cystatin C-based estimating equations to mGFR, modelled and validated a new creatinine-based equation, and developed a multiple imputation model trained on the mGFR sample using age, sex, and creatinine as the variables to predict the population prevalence of impaired kidney function in west, east, and southern Africa.Of 3025 people who underwent measured GFR testing (Malawi n=1020, South Africa n=986, and Uganda n=1019), we analysed data for 2578 participants who had complete data and adequate quality measurements. Among 2578 included participants, creatinine-based equations overestimated kidney function compared with mGFR, worsened by use of ethnicity coefficients. The greatest bias occurred at low kidney function, such that the proportion with GFR of less than 60 mL/min per 1·73 mEstimating GFR using serum creatinine substantially underestimates the individual and population-level burden of impaired kidney function in Africa with implications for understanding disease progression and complications, clinical care, and service provision. Scalable and affordable ways to accurately identify impaired kidney function in Africa are urgently needed.The GSK Africa Non-Communicable Disease Open Lab.For the Luganda, Chichewa and Xitsonga translations of the abstract see Supplementary Materials section.

BACKGROUND: Positron emission tomography detects patients with myocardial contractile dysfunction secondary to ischaemic heart disease who may benefit from coronary revascularisation. METHODS: We reviewed technetium-99m sestamibi singlephoton emission computed tomography (SPECT) and fluorine- 18 fluorodeoxyglucose (F18-FDG) positron emission tomography (PET) data from 236 patients imaged between January 2009 and June 2015. The patients were grouped into three groups: no evidence of viability, viability 1–10% and viability > 10%. RESULTS: Viability exceeding 10% was evident in 55% of the patients. On multivariate analysis, aspirin intake [OR: 1.92; 95% CI: 1.08–3.41; p = 0.026] and hypertension [OR: 1.89; 95% CI: 1.07–3.33; p = 0.029] were clinical factors associated with the presence of myocardial viability. CONCLUSION: Our study demonstrated that F18-FDG PET was able to identify 55% of patients with ischaemic heart disease with viability in more than 10% of the total myocardium when using a 17-segment model.