Joan J Rugemalila
Muhimbili National Hospital, Tanzania
Title: Predictors associated with moderate to severe chronic kidney disease among HIV infected adult patients in Dar es Salaam, Tanzania
Biography
Biography: Joan J Rugemalila
Abstract
Background: There is limited evidence of kidney disease and risk factors among people with HIV/AIDS in East Africa. The aim of this study was to determine the risk factors associated with moderate to severe chronic kidney disease (CKD) among HIV patients in Dar es Salaam, Tanzania.
Methods: A cross-sectional analysis of the baseline clinical data for 30,822 HIV-infected adult patients presented at HIV/AIDS care and treatment centers (CTC) in Dar es Salam, Tanzania was done. CKD was defined as presence of estimated glomerular filtration rate (eGFR<60 mL/min). Log binomial regression models were used to estimate relative risks and predictors of CKD.
Results: The overall prevalence of CKD was 11%. In multivariate adjusted analysis, CKD at the time of enrollment into care was significantly associated with age <30 years (RR 0.71, 95% CI 0.63-0.80) and age ≥50 years (RR: 1.93, 95% CI 1.76-2.15), compared with age 30≤40 years. Patients with clinical stage IV (RR 1.32, 95% CI 1.21-1.44) and alanine aminotransferase (ALT)>200 U/L (RR 1.80, 95% CI 1.13-2.86) were also at higher risk. Hemoglobin <7 g/dl (RR 1.67, 95% CI 1.52-1.83) and CD4<100 cells/mm3 (RR 1.18, 95% CI 1.04-1.34) were also associated with prevalence of CKD.
Conclusion: CKD was prevalent at the time of enrollment into care. Advancing age, ALT levels and advanced WHO clinical stage were major risk factors for CKD among HIV patients enrolling for care.