Belete Abebe Muche, Yazie Taklo Simeneh
Department of Medicine, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Amhara, Ethiopia.
Pharmacology Unit and Research Team, Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia.
HIV AIDS (Auckl). 2021 Mar 16;13:301-306. doi: 10.2147/HIV.S299596. eCollection 2021.
Life expectancy of HIV patients has increased by the extensive use of antiretroviral therapies (ART), but ART predisposes patients to chronic non-communicable diseases including chronic kidney disease (CKD). Tenofovir disoproxil fumarate is one of the commonly used drugs in ART and is found to have more risk for developing CKD. In the study areas, there was no previous study addressing the prevalence of CKD, so the purpose of this study was to pinpoint the prevalence of CKD, and its associated factors.
A hospital-based cross-sectional study was employed at Tikur Anbessa Specialized Hospital (TASH) and Zewuditu Memorial Hospital (ZMH) from April 1 to June 30, 2019. The study participants were proportionally allocated to each hospital and a total of 243 eligible participants were selected conveniently from the two hospitals in the study period. Structured questionnaire and checklist were used to collect socio-demographic and clinical data of the participants. Blood samples (3-5 ml) were used to determine serum creatinine using calibrated fully automated Mind ray BS-200E, and glomerular filtration rate (GFR) was estimated using a chronic kidney disease epidemiology equation. Multivariate logistic regression was employed to identify factors associated with CKD, and a P-value of less than 0.05 was considered significant.
In the present study, the prevalence of CKD (GFR <60 ml/min/1.73 m) was 4.53% (95% CI = 2.3-8%). GFR was classified into stages, stage 5 (GFR <15), stage 4 (15-29.9), stage 3 (30-59.9), stage 2 (60-89.9), and stage 1 (≥90) were 0%, 0.4%, 4.1%, 38.3%, and 57.2%, respectively. In the multivariate logistic regression, age greater than 50 years old, and having cancer were significantly associated with CKD (AOR: 0.22, 95% CI = 0.05-0.88, P = 0.033, and AOR: 18.20, 95% CI = 122-271.77, P = 0.035, respectively).
Chronic kidney disease in HIV-infected patients receiving a TDF-based regimen requires attention. Age >50 years old, and having cancer as comorbidity were significantly associated with chronic kidney disease. Patients should be regularly monitored for early diagnosis and management of chronic kidney disease in a TDF-based regimen.
通过广泛使用抗逆转录病毒疗法（ART），HIV患者的预期寿命有所增加，但ART使患者易患慢性非传染性疾病，包括慢性肾脏病（CKD）。富马酸替诺福韦二吡呋酯是ART中常用的药物之一，被发现有更高的患CKD风险。在研究地区，之前没有关于CKD患病率的研究，因此本研究的目的是确定CKD的患病率及其相关因素。
2019年4月1日至6月30日，在提库尔·安贝萨专科医院（TASH）和泽乌迪图纪念医院（ZMH）进行了一项基于医院的横断面研究。研究参与者按比例分配到每家医院，在研究期间从两家医院方便地选取了243名符合条件的参与者。使用结构化问卷和检查表收集参与者的社会人口统计学和临床数据。采集血样（3 - 5毫升），使用校准后的全自动迈瑞BS - 200E测定血清肌酐，并使用慢性肾脏病流行病学方程估算肾小球滤过率（GFR）。采用多因素逻辑回归分析确定与CKD相关的因素，P值小于0.05被认为具有统计学意义。
在本研究中，CKD（GFR<60 ml/min/1.73 m²）的患病率为4.53%（95%CI = 2.3 - 8%）。GFR分为5期，5期（GFR<15）、4期（15 - 29.9）、3期（30 - 59.9）、2期（60 - 89.9）和1期（≥90）的患病率分别为0%、0.4%、4.1%、38.3%和57.2%。在多因素逻辑回归分析中，年龄大于50岁和患有癌症与CKD显著相关（调整后比值比分别为：0.22，95%CI = 0.05 - 0.88，P = 0.033；18.20，95%CI = 1.22 - 271.77，P = 0.035）。
接受基于替诺福韦酯（TDF）方案治疗的HIV感染患者中的慢性肾脏病需要引起关注。年龄>50岁和合并癌症与慢性肾脏病显著相关。对于接受基于TDF方案治疗的患者，应定期监测以早期诊断和管理慢性肾脏病。
