Chronic kidney disease and its predictors among highly active antiretroviral therapy naïve and experienced HIV-infected individuals at the selected hospitals, Southwest Ethiopia: a comparative cross-sectional study

Abstract

ObjectiveThis study aimed to determine the prevalence of chronic kidney disease (CKD) and its predictors among highly active antiretroviral therapy (HAART) naïve and experienced HIV-infected individuals.Method and analysisHospital-based comparative cross-sectional study design was used at Mizan-Tepi University Teaching Hospital, Bonga General Hospital and Tepi General Hospital. A total of 616 naïve and experienced HIV-infected individuals participated. A systematic random sampling and consecutive sampling methods were applied to select the HAART experienced and naïve HIV-infected individuals, respectively. Descriptive statistics were used for all study variables. Independent t-test and logistic regression analysis were performed to compare the mean between naïve and experienced patients and to identify its predictor variables considering a <0.05 and 95% CI, respectively.ResultsA total of 616 HIV-positive respondents were enrolled in this study. The prevalence of CKD was 41 (29.3%) of 140 and 78 (16.4%) of 476 HAART-naïve and HAART-experienced HIV patients, respectively. Rural residency, being anaemic, being hypertensive, having had a family history of kidney disease and stage IV current WHO) clinical stage were independent risk factors of CKD among naïve HIV patients, whereas, rural residency, utilisation of drinking water per day below the recommended amount, being anaemic, being hypertensive, stage IV current WHO clinical stage and obesity were predictors of CKD among experienced HIV patients. Statistically significant difference was observed between HAART naïve and HAART experienced participants with regard to the mean glomerular filtration rate level (t=−3.987, 95% CI −18.29 to −6.22).ConclusionCKD was higher among HAART-naïve than HAART-experienced study participants. Therefore, early initiation of antiretroviral therapy (ART) drugs, modification of lifestyles to decrease obesity and early detection and treatment of comorbidities such as anaemia and hypertension may have profound effects in reducing CKD and increasing patients’ quality of life.

Mechanisms and Cardiorenal Complications of Chronic Anemia in People with HIV

“…Several factors, including HIV-associated nephropathy, erythropoietin deficiency, chronic inflammation, and the nephrotoxic effects of antiretroviral medications, contribute to the heightened risk of chronic kidney disease (CKD) in the presence of chronic anemia [ 106 , 107 ]. HIV-related immunosuppression and comorbidities such as opportunistic infections further amplify the impact of anemia on renal health [ 108 ].…”