Abstract

Human Immunodeficiency Virus (PLHIV) and Acquired Immunodeficiency Syndrome (AIDS) patients have increased risk for kidney diseases, including HIV-Associated Nephropathy (HIVAN), non-collapsing focal segmental glomerulosclerosis, immune-complex kidney disease, and comorbid kidney disease, kidney injury following long term use of Highly Active-antiretroviral Therapy (HAART) or opportunistic infections medications. In this population, kidney dysfunction is now an increasingly recognized non-AIDS defining condition, and contributes to the increased morbidity and mortality of PLHIV. The role of HIV-related factors in kidney dysfunction still remains unclear. This hospital-based retrospective cross-sectional study investigates the prevalence and factors associated with kidney dysfunction in HIV people attending Care and Treatment Clinics (CTC) at Kilimanjaro Christian Medical Centre (KCMC) in Northern Tanzania. Clinical records of PLHIV were examined from October 2022 to April 2023. Participants included PLHIV on HAART for above 6 months. Serum creatinine was used to estimate eGFR using the 2021 CKD-EPI equation excluding race. Data were analyzed using STATA 14. Multivariate analysis was conducted and P < 0.05 indicated statistical significance. Among the 331 PLHIV on HAART who met the inclusion criteria, 40(12.1%) had impaired kidney function, based on an estimated glomerular filtration rate of ≤60 mL/min/1.73m2, 32 had an eGFR of 30 to 59 mL/min/1.73 m2, 2 had an eGFR of 15 to 29 mL/min/1.73 m2, and 6 had an eGFR of < 15 mL/min/1.73 m2. Anaemia (adjusted odds ratio [AOR] = 3.37, 95% confidence interval [CI]: 1.35-8.42) and femininity (AOR = 4.18, 95% CI: 1.42-8.19) were independent predictors of renal function impairment. Approximately one tenth of the patients had renal function impairment, with half being anaemic. Anaemia and being a woman correlated with impaired kidney function. For this population, routine screenings are recommended for early detection and treatment of anemia and renal function impairment.

Key words: Kidney dysfunction, renal impairment, HIV positive, people living with HIV, HAART, Kilimanjaro Christian Medical Centre.