Abstract
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(2). 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% (n = 237). The prevalence of kidney impairment was 10.7% (n = 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, p < 0.001) and (aOR 2.44; 95% CI: 1.02, 5.79, p = 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.