A study on prevalence and risk factors of renal dysfunction among Hospitalized HIV infected adult patients at the University Teaching Hospital, Lusaka

Abstract

Despite the highest disease burden of HIV, Sub-Saharan Africa has limited data on HIV related kidney disease in the region. Kidney disease is a recognised complication in HIV infected patients, presenting with either can be acute renal failure (ARF) or chronic kidney disease (CKD). This study investigated the prevalence and factors associated with renal dysfunction among hospitalised HIV infected patients at the University Teaching Hospital (UTH), Lusaka. Methodology- This was a cross sectional study that was conducted at the University Teaching Hospital Lusaka, Zambia. Enrolment of all eligible participants started from August 2010 to October, 2010. Inclusion criteria were hospitalised patients aged 16years and above who consented to the study. Qualified HIV counselors were used to counsel the patients. After obtaining demographic information, study participants were screened for HIV upon their consenting for the test. A full clinical history and examination was done by study physician to determine the factors associated with renal dysfunction.Results- Of the 300 recruited hospitalised patients in this cross sectional study, 154(51%) were males. In HIV infected patients mean SD was 35.6(9.5) and 44.1(20.0) in uninfected HIV infected subjects. Our study observed a significantly higher prevalence of renal dysfunction among hospitalised HIV infected patients (42%) compared to (27%) among uninfected HIV patients p=0.006 and 2fold increased likelihood of developing kidney dysfunction; 1.96(1.21-3.17). WHO stage III was associated with renal dysfunction in HIV infected patients. Tenofovir a first line antiretroviral drug in Zambia wasn’t associated with renal dysfunction. Mean arterial pressure (MAP) <65mmHg was not associated with kidney disease in multivariable analysis.Conclusion-Renal dysfunction is significantly higher among hospitalised HIV infected compared to uninfected patients