Mutalange Matenge, Siame Lukundo, Cheelo Chilala, Masenga Sepiso K, Hamooya Benson M
Department of Pathology and Microbiology, School of Medicine and Health Sciences, Mulungushi University, P. O. Box 60009, Livingstone 10101, Zambia.
School of Medicine and Health Sciences, Mulungushi University, Kabwe, Zambia.
Ther Adv Infect Dis. 2025 Jun 5;12:20499361251340795. doi: 10.1177/20499361251340795. eCollection 2025 Jan-Dec.
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.
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.
This was a retrospective cross-sectional study.
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.
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.
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.
从无症状性肾脏损害到终末期肾病，肾脏疾病仍是全球公共卫生关注的问题。肾脏疾病已被证明是艾滋病毒感染者（PLWH）死亡和发病的重要原因。然而，在资源有限的环境中，关于肾脏损害的负担和危险因素的数据有限。
本研究旨在确定赞比亚一家三级医院接受抗逆转录病毒治疗（ART）的PLWH中肾脏损害的患病率及其相关因素。
这是一项回顾性横断面研究。
本研究纳入了374名年龄≥18岁且接受ART治疗≥6个月的PLWH。我们从一项关注PLWH代谢综合征的研究中获取了临床、实验室和人口统计学特征。肾脏损害定义为估计肾小球滤过率（eGFR）<60 ml/min/1.73m²。使用STATA 15版进行数据分析。采用多变量逻辑回归确定与肾脏损害相关的因素。
研究参与者的中位年龄为44岁，大多数为女性，占63.4%（n = 237）。肾脏损害的患病率为10.7%（n = 40）。在考虑ART治疗时间、性别和血压（收缩压和舒张压）后，年龄较大以及采用基于多替拉韦（DTG）和替诺福韦酯/拉米夫定（TDF/3TC）的治疗方案与肾脏损害呈正相关（调整优势比[aOR]为1.09；95%置信区间：1.05，1.14，P < 0.001）和（aOR为2.44；95%置信区间：1.02，5.79，P = 0.043）。
肾脏损害在成年PLWH中很常见，且与年龄较大以及采用基于DTG和TDF/3TC的治疗方案显著相关。有必要定期监测艾滋病毒感染者的肾功能，尤其是采用基于DTG和TDF/3TC治疗方案的老年人。
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