Prevalence and predictors of renal dysfunction among people living with HIV on antiretroviral therapy in the Southern Highland of Tanzania: a hospital-based cross-sectional study

Mwanjala, Mololo Noah; Urio, Loveness John; Mtebe, Majigo Venance

doi:10.11604/pamj.2022.41.137.27025

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…In addition, as renal dysfunction results from viral infestation on the renal parenchyma, therefore, low-level viremia reduces the risk of renal damage (Chou & Chen, 2021). Similarly, our findings concur with the findings in a cohort study in Mwanza ( Mpondo et al, 2014), but differs from the report of the study in the southern highlands part of Tanzania (Mwanjala, Urio, & Mtebe, 2022).…”

Section: Discussionsupporting

confidence: 87%

Burden and Factors Associated with Renal Dysfunction among People Living with HIV in Dar es Salaam, Tanzania

Kitambala,

Amani,

Njiro

et al. 2024

GJHS

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Renal diseases pose a significant burden of morbidity and mortality, particularly among People Living with HIV (PLHIV). The risks are further compounded by drug-induced renal toxicity, and the growing burden of hypertension, diabetes, and Hepatitis C infections. This study assessed the magnitude and factors associated with renal dysfunction among PLHIV attending clinics in Dar es Salaam, Tanzania. A hospital-based cross-sectional study was conducted between January and March 2022 among 331 PLHIV recruited through a multistage sampling. Renal disease was determined through urine analysis and clinical, demographic, and disease-specific data were collected using a structured questionnaire. The analysis, performed in SPSS version 25, involved descriptive analysis, univariate, and multivariable logistic regression to determine the magnitude and predictors of renal dysfunction among PLHIV. Renal dysfunction was observed in 37 (11.1%) participants. Patients with advanced age were 3.89 times more likely to have renal dysfunction (95% CI: 1.56 – 9.72, p = 0.004) compared to lower age groups. No statistically significant association was found between renal dysfunction and sex, duration from diagnosis of HIV and on ART, ART-based regimen, HIV viral load, hypertension, or diabetes mellitus. More than one in ten PLHIV in Dar es Salaam, Tanzania, presented with signs of renal dysfunctions, which was more significant among patients aged 55 and older. Routine screening for renal diseases among PLHIV, especially for patients with advanced age is essential to prevent and control for progression to renal failure.

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Section: Discussionsupporting

confidence: 87%

Burden and Factors Associated with Renal Dysfunction among People Living with HIV in Dar es Salaam, Tanzania

Kitambala,

Amani,

Njiro

et al. 2024

GJHS

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“…There was no sex predominance also, which is parallel with other study [24]. However, Female gender predominance was observed by one study [8]. The increase in mean weight of all patients from start of ART to the time of study shows that ART improved general wellbeing.…”

Section: Resultssupporting

confidence: 78%

“…TDF became famous because of the convenient dosing schedule, better efficacy, and less side effect [6]. But the resemblance of its structure to that of nephrotoxic acyclic nucleotide analogues adefovir and cidofovir has raised various concerns about its safety [7,8]. Tenofovir alafenamide and tenofovir disoproxil fumarate are two formulations of tenofovir approved by FDA.…”

Section: Introductionmentioning

confidence: 99%

Nephrotoxıcıty in Patıents on Tenofovır vs Non-Tenofovır Contaınıng Art Regımen: An Observatıonal Study

Agrawal¹,

Shrivastava²,

Khare³

et al. 2022

Pharmacophore

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Treatment of Human Immunodeficiency Virus (HIV) infection has been revolutionized by the newer generation of Anti-Retroviral therapy (ART). The first-line ART comprises of NRTI (Tenofovir plus Lamivudine) and one NNRT, Efavirenz. The renal tubular dysfunction associated with Tenofovir is an adverse effect of concern. This study was undertaken to find the incidence of nephrotoxicity due to Tenofovir based regimen in comparison to non TLE regimen. A nonrandomised cross-sectional study with 50 patients between 18-60 years already on ART regimen were included in each arm-TLE and non TLE. Nephrotoxicity was diagnosed if there was: 1) increase serum creatinine 2) Decrease Serum Uric Acid 3) abnormal spot urine albumin creatinine ratio 4) decrease blood haemoglobin concentration. Statistical analysis was done using Fischer's exact test. TLE and ZLN were the two most frequently prescribed regimen. Four patients [8% (p value 0.059)] developed nephrotoxicity in the TLE regimen as compared to none from the non-TLE regimen. Longer exposure to TLE regimen was a predisposing factor for nephrotoxicity as 3 patients were on tenofovir for more than 4 years but independent of age, body weight, or CD4 count. Anaemia was observed in 48% of patients on TLE vs 18% in non TLE regimen. 26% of patients on Tenofovir based regimen had an abnormality in at least one of the four parameters. Using Tenofovir alafenamide or shifting to an alternate regimen when early signs of renal injury are visible will prevent nephrotoxicity.

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“…Of the twenty-four studies, five were from Ethiopia [19][20][21][22][23], four from Tanzania [24][25][26][27], four from Nigeria [28][29][30][31], two from Uganda [32,33], one from Kenya [34], one from Cameroon [35], one from South Africa [36], one from Malawi [37], one from Senegal [38], one from Zambia [39], one from Rwanda [40], one from Burkina Faso [41], and one from DR Congo [42]. The pooled prevalence was calculated from the aforementioned studies, whereas for predictors of AKI, three studies for hemoglobin level [19,35,41], six studies for CD4 count [19,20,[24][25][26]31], and three studies for WHO clinical HIV staging [20,26,35] were used. The prevalence of AKI among HIV patients ranged from 2.53% in Uganda [33] to 56.8% in Nigeria [31].…”

Section: Study Selection and Characteristics Of Included Studiesmentioning

confidence: 99%

Acute kidney injury and its predictors among HIV-positive patients in Africa: Systematic review and meta-analysis

Azagew,

Abate,

Ferede

et al. 2024

PLoS ONE

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Background cute kidney injury(AKI) is a rapid loss of the kidney’s excretory function, resulting in an accumulation of end products of nitrogen metabolism. The causes of AKI in HIV-positive patients are not well investigated, but it may be associated with antiretroviral drug side effects and HIV itself. Even though there were studies that reported the prevalence of AKI among HIV-positive patients in Africa, their findings were inconsistent across the studies. Methods We searched on PubMed, Embas, Ebsco, OVID, Cochrane Library, and other supplementary search engines, including Google and Google Scholar. Articles published upto July 2023 were included in this review study. The quality of the study was assessed using the Newcastle-Ottawa Scale for cross-sectional, case-control, and cohort studies. The data were extracted using a Microsoft Excel spreadsheet and exported to Stata version 14 for analysis. A random effect meta-analysis model was used to estimate the pooled prevalence of AKI among HIV-positive patients. Heterogeneity was evaluated using Cochrane Q statistics and I squared (I2). Furthermore, the graphic asymmetric test of the funnel plot and/or Egger’s tests were computed to detect publication bias. Sensitivity analysis was computed to see the effect of a single study on the summary effects. To treat the publication bias, a trim and fill analysis was carried out. The protocol of this review has been registered in an international database, the Prospective Register of Systematic Reviews (PROSPERO),with reference number CRD42023446078. Results A total of twenty-four original articles comprising 7913HIV-positive patients were included in the study. The pooled prevalence of AKI among HI-positive patients was found to be 23.35% (95% CI: 18.14–28.56%, I2 = 97.7%, p-value <0.001). Low hemoglobin (Hgb <8mg/dl) was found to be the determinant factor for AKI among HIV-positive patients (AOR = 2.4; 95% CI:1.69–3.4, I2 = 0.0%, p-value = 0.40). In meta-regression analysis, sample size was the possible source of variation among the included studies (AOR = 3.11, 95%CI: 2.399–3.83). Conclusions The pooled prevalence of AKI among HIV-positive patients was high. HIV-positive patients with low hemoglobin levels are at risk of developing AKI. Hence, regular monitoring of kidney function tests is needed to prevent or delay the risk of AKI among HIV-positive patients. Healthcare workers should provide an integrated healthcare service to HIV-positive patients on the prevention, treatment, and reduction of the progression of AKI to advanced stages and complications.

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Prevalence and predictors of renal dysfunction among people living with HIV on antiretroviral therapy in the Southern Highland of Tanzania: a hospital-based cross-sectional study

Cited by 5 publications

References 23 publications

Burden and Factors Associated with Renal Dysfunction among People Living with HIV in Dar es Salaam, Tanzania

Burden and Factors Associated with Renal Dysfunction among People Living with HIV in Dar es Salaam, Tanzania

Nephrotoxıcıty in Patıents on Tenofovır vs Non-Tenofovır Contaınıng Art Regımen: An Observatıonal Study

Acute kidney injury and its predictors among HIV-positive patients in Africa: Systematic review and meta-analysis

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