The prevalence and predictors of renal dysfunction in hiv positive people at jimma university specialized hospital, south west Ethiopia.

Abstract

Background Renal disease is a significant cause of morbidity and mortality among people living with the human immunodeficiency virus (HIV).However, little is known about renal dysfunction among people living with HIV/AIDS in Sub-Saharan Africa. Methods; A cross-sectional survey was conducted from May to July, 2012 at outpatient HIV-clinic in Jimma university specialized hospital (JUSH). Renal dysfunction was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2 and/or detectable urine protein. Multiple binary logistic regression analysis was used to analyze associated factors for renal dysfunction in HIV infected individuals. Results; A sample of 321 patients was included in the study. The mean (±SD) age of patients was 36 ± 9.74 and, 58.3% were females. The median current CD4 count was 328cells/mm3.The prevalence of renal dysfunction was 15.9% (n=51). Factors associated with renal dysfunction were age, CD4 count and duration of tenofovir use. Accordingly for age,(OR 3.6 for age group (31-42) , p <0.025),(OR 4.5 for age group (43-53) , p <0.025) and (OR 22.7 for age group 54+,p <0.001) compared to age group (19-30), lower CD4 nadir (OR 9.7 for CD4 < 200 cells/mm3 compared to CD4 ≥ 200cells/mm3, p <0.001), and duration of tenofovir use (OR 18.5 for duration ≥ 12months compared to non users , p<0.001). Conclusion; Renal dysfunction was relatively common in these HIV positive individual. Likewise longer duration of tenofovir use, individuals having CD4 nadirs of < 200 cells/mm3 and increasing age were found to be associated with increased risk of renal dysfunction. So, screening for urine protein and serum creatinine should be routine. Further studies with long-term follow-up to see the incidence of CKD and related risk factors is mandatory.