Kidney impairment in HIV: an insight into the burden and associated factors among adults on antiretroviral therapy in Zambia. A retrospective cross-sectional study.

BACKGROUND

Kidney disease, ranging from asymptomatic kidney impairment to end-stage renal disease, remains a public health concern globally. Kidney diseases have been shown to be a significant cause of mortality and morbidity among people living with HIV (PLWH). However, there is limited data on the burden and risk factors for kidney impairment in resource-limited settings.

OBJECTIVES

This study aimed to determine the prevalence and factors associated with kidney impairment among PLWH receiving antiretroviral therapy (ART) at a tertiary hospital in Zambia.

DESIGN

This was a retrospective cross-sectional study.

METHODS

This study consisted of 374 PLWH aged ⩾18 years and on ART for ⩾ 6 months. We obtained clinical, laboratory, and demographic characteristics from a study that focused on metabolic syndrome among PLWH. Kidney impairment was defined as having an estimated glomerular filtration rate (eGFR) of <60 ml/min/1.73 m. Data was analyzed using STATA version 15. Multivariable logistic regression was used to ascertain factors associated with kidney impairment.

RESULTS

The median age among the study participants was 44 years, and the majority were females, 63.4% ( = 237). The prevalence of kidney impairment was 10.7% ( = 40. After accounting for duration on ART, sex and blood pressure (systolic and diastolic), older age and being on a Dolutegravir (DTG) and tenofovir disoproxil fumarate/lamivudine (TDF/3TC) based regimen was positively associated with kidney impairment (adjusted odds ratio (aOR) 1.09; 95% CI: 1.05, 1.14,  < 0.001) and (aOR 2.44; 95% CI: 1.02, 5.79,  = 0.043), respectively.

CONCLUSION

The prevalence of kidney impairment was common among adult PLWH and was significantly associated with older age and the use of a DTG and TDF/3TC-based regimen. There is a need to regularly monitor kidney function among people with HIV, especially older people who are on a DTG and TDF/3TC-based regimen.