A study on the prevalence of kidney dysfunction and associated risk factors among ART-Naive HIV-1 infected adults at the University Teaching Hospital in Lusaka,Zambia

Abstract

Background: Chronic HIV infection is associated with renal complications including renal dysfunction. Risk factors found in literature for kidney disease in the HIV population include hypertension, diabetes mellitus, cardiovascular disease, low CD4 count, high viral load, hepatitis C virus co-infection, hypoalbuminemia, and a family history of CKD, black race, nephrotoxic drugs including antiretroviral medication. Other factors implicated being underweight, obesity, herbal medication use, chronic NSAID use. No local studies have been done to validate these risk factors in our ART naïve HIV infected adult population. General objective: To determine the prevalence of renal dysfunction and associated risk factors in ART naïve HIV infected adults at the University Teaching Hospital, Lusaka. Methods: This was a cross sectional analytical study which enrolled 206 participants from outpatient care service points and from the inpatient wards. A structured questionnaire was used to collect data and blood and urine samples collected for tests. Data was entered onto a Microsoft office excel spread sheet, and analysed using STATA version 13. We first looked at the proportion of renal dysfunction among the participants. We then investigated the association between the dependent variable and each independent variable using chi square. All variables that were significant and those variables that are known in literature to be associated with renal dysfunction were included in the logistic regression. A backward stepwise regression was used to come up with a model for our study. Results: The prevalence of renal dysfunction was 24.76%. The mean age for the whole sample population was 36.62 (renal=37.53 and non-renal 35.47). The study population comprised more females (54.63%) than males. Hypertension OR=2.63, (95% CI 1.11, 6.12) was the only factor found to be predictive of renal dysfunction.

Conclusion: The prevalence of renal dysfunction among ART naïve HIV infected adults was high. Hypertension was the only factor found to be predictive of renal dysfunction.