<p>Chronic Kidney Disease and Associated Factors Among HIV/AIDS Patients on HAART in Ethiopia</p>

Abstract

Background: In developing countries, both opportunistic infections and chronic diseases account a high HIV-associated mortality and morbidity. Chronic kidney disease (CKD) associated with HIV infection has got increased attention in sub-Saharan Africa as a result of the high HIV prevalence and due to the late diagnosis and initiation of HAART. Thus, this study was conducted to assess CKD and associated factors among HIV patients on HAART in Ethiopia. Methods: A hospital-based cross-sectional study with a secondary data review was conducted on 336 on HIV/AIDS patients on HAART from February to July 2017 at University of Gondar Referral Hospital. The study participants were selected using a systematic random sampling technique. Socio-demographic and clinical data were collected using a semistructured questionnaire at their follow-up date with interview and chart review. Three to five milliliters of venous blood and five milliliters of urine specimen were collected for serum creatinine and urine albumin determination, respectively. Data were entered into SPSS version 20 for analysis. Glomerular filtration rate was estimated using the CKD-EPI estimator. Bivariate and multivariate logistic regression was employed and p-value <0.2 and < 0.05, respectively, was considered statistically significant. Results: The prevalence of CKD on the study participants was 54 (16.1%) (95% CI, 12.2-20.4%). By stage, about 27 (8.0%) had stage 1 (persistent proteinuria with eGFR ≥ 90 mL/min/ 1.73 m 2), 16 (4.8%) had stage 2 (persistent proteinuria with eGFR of 60-89.9 mL/min/1.73 m 2), 6 (1.8%) had stage 3 (eGFR 30-59.9 mL/min/1.73 m 2 with or without proteinuria) and 5 (1.5%) had stage 5 ((kidney failure), eGFR<15mL/min/1.73 m 2 with or without proteinuria). With multivariate logistic regression analysis, being male (AOR=2.05 (1.03-4.09), p=0.04), being merchant (AOR=2.91 (1.00-8.48), p=0.049) and having viral load≥1000 copies/mm 3 (AOR=3.1 (1.38-7.00), P<0.01) were significantly associated with CKD. Conclusion: The prevalence of CKD among HIV patients on HARRT is high. Being male, merchant and having viral load ≥1000 copies/mm 3 were associated factors of CKD. Patients should be regularly monitored and screened for early diagnosis and management of CKD. Those patients who have being merchant with high viral load and male patients should require close monitoring.

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

“…29 Thus, determining the prevalence and contributing factors for different comorbidities such as CKD is important to improve the quality of life and long-term healthcare management of PLHIV. 30 Despite there are some studies conducted in other parts of Ethiopia, [31][32][33] still there is a paucity of studies related to CKD and its predictors among HAART naïve and HAART experienced HIV patients in this study area. Therefore, this study aimed to determine the prevalence of CKD and associated factors among HAART naïve and HAART experienced HIV-infected individuals at the selected Hospitals (Bonga G/tsadik Shawo General Hospital, Mizan Tepi University Teaching Hospital (MTUTH) and Tepi General Hospital), Southwest Ethiopia.…”

The incidence and dynamic risk factors of chronic kidney disease among people living with HIV – A population-based Cohort Study

“…A randomized trial conducted by the SMART study group indicated the renal events rate declined significantly when the patients were treated following the standard guidelines and achieved sustained viral suppression [32]. And recent research shows patients with HIV viral load more than 1000 copies/ml had over three times the risk of CKD compared with undetectable viral load [21]. There is a counterintuitive finding that participants with an initial CD4 þ cell count between 200 and 350 cells/ml were more likely to develop CKD compared with their counterparts who had an initial CD4 þ cell count less than 200 cells/ml.…”

“…Little is known of CKD incidence in Southern states of the USA. Second, the majority of studies are restricted to examining the risk factors at a single timepoint [21], while risk factors such as different ART eras and aging process have evolved over time. Third, a number of studies used single or only baseline measurements of HIV-related factors [9] due to the short follow-up time or restriction of data collection, which lacks sufficient longitudinal measurement.…”

Renal Function Evaluation of HAART and HAART-Naïve HIV/AIDS Patients in Makurdi, Nigeria

“…Current study had few limitations, no baseline renal function was done to evaluate the change in renal function over time thereby allowing for short-term impairment that may be reversible. Also, microalbuminuria was not evaluated, as it has been demonstrated to be a vital indicator for renal dysfunction identification in HIV-infected individuals 24,25 .…”