PA-416 Chronic kidney disease prevalence among antiretroviral therapy naïve patients in Lagos, Nigeria

• Published in: BMJ global health 2023-12, Vol.8 (Suppl 10), p.A79-A79
• Main Authors: Odubela, Oluwatosin, Odunukwe, Nkiruka, Peer, Nasheeta, Salako, Babatunde Lawal, Kengne, Andre Pascal
• Format: Article
• Language: English
• Subjects: Abstracts of Poster and e-Poster Presentations; Anemia; Antiretroviral drugs; Drug therapy; HIV; Human immunodeficiency virus; Hypertension; Kidney diseases; Tuberculosis
• ISSN: 2059-7908
• DOI: 10.1136/bmjgh-2023-EDC.193

BackgroundAntiretroviral therapy (ART) has improved the survival of people living with HIV (PLWH). With improved lifespan, there is increased risk of Non-communicable diseases (NCDs), notably Chronic kidney disease (CKD). This study aims to determine CKD’s prevalence and associated factors among ART-naïve PLWH in Nigeria.MethodsThis is a secondary data analysis of ART naïve PLWH enrolled over six years (2014 – 2019) at a large treatment center in Lagos. Data collected include sociodemographic characteristics, weight, height, concurrent co-morbidities (hypertension, diabetes mellitus, and tuberculosis), and HIV-specific factors (WHO clinical stage, viral load, and CD4 counts). CKD was defined as an estimated glomerular filtration rate less than 60ml/min/m2 using the three equations [Body surface area corrected Cockcroft Gault (BSA-CG), Modification of Diet in Renal Disease (MDRD), and Chronic kidney disease Epidemiology Collaboration (CKD-EPI)]. Ethical approval was obtained before the study commencement.ResultsA total of 2782 PLWH were included in the study, with a mean age of 37.9 (± 9.8) years. A significant proportion of study participants were females (62.2%), had at least secondary school education (58.8%), were married (54.8%), employed (85.7%), and did not consume alcohol (76.6%). Hypertension (21.1%) and tuberculosis (6.1%) were the predominant co-morbidities. A significant proportion of participants were in WHO stages 1 or 2 (55.5%), had CD4 counts less than 500 cells/mm3 (75%), and were virally suppressed (71.7%). The age-standardized prevalence of CKD was 10.0% (8.6 – 11.4), 17.2% (15.4 – 19.0), and 13.1% (11.5 – 14.7) using the BSA-CG, MDRD, and CKD-EPI equations, respectively. Increasing age and anaemia were found to predict the presence of CKD, irrespective of the equation used.ConclusionThe prevalence of CKD is relatively high, and age and anaemia were significant predictors. Therefore, comprehensive care is needed to ensure close monitoring of PLWH for CKD and associated predictive factors.