PREVALENCE OF CHRONIC KIDNEY DISEASE AND ASSOCIATED FACTORS AMONG ADULT HIV/AIDS PATIENTS ON HAART IN HARAMAYA UNIVERSITY HIWOT FANA COMPREHENSIVE SPECIALIZED HOSPITAL, HARAR, EASTERN ETHIOPIA

Abstract

Background:One of the non-communicable diseases that results in substantial morbidity and death globally is chronic kidney disease. It is also a risk factor for renal failure and cardiovascular disease. In sub-Saharan Africa, chronic kidney disease related to human immunodeficiency virus infection has gained great attention due to the high prevalence of human immunodeficiency virus, delayed diagnosis, and the initiation of highly active antiretroviral therapy. In addition, there is limited data regarding chronic kidney disease and its associated factors among human immunodeficiency virus patients receiving highly active antiretroviral therapy in Ethiopia as well as in Harar. Objective: The purpose of this study is to determine the prevalence and factors associated with chronic kidney disease amonghuman immunodeficiency viruspatients receivinghighly active antiretroviral therapy in Haramaya University Hiwot Fana Comprehensive Specialized Hospital, Harar, Eastern Ethiopia, from November 20, 2023, to February 22, 2024. Methods: A hospital-based cross-sectional study was carried out, and 228 study participants were enrolled using a consecutive convenient sampling technique.Study participants provided 5 ml of blood for serum creatinine measurement and 10 ml of urine sample for a urine protein test. Serum creatinine was measured by Cobas C311 analyzer (Roche Diagnostics International Ltd., Rotkreuz, Switzerland) and urine by a urine dipstick tests (Shanghai SNWI Co Ltd., Shanghai, China).Chronic kidney disease was defined as estimate glomerular filtration rate< 60 ml/min/1.73m² or the presence of persistent proteinuria lasting for >3 months, even when estimate glomerular filtration rate ≥ 60 ml/min/1.73m². Trained laboratory professional and nurse utilized semi-structured questionnaires to gather sociodemographic clinical, and lifestyle data. The collected data were entered into EpiData version 4.6 and then exported to SPSS version 27 for analysis. Bivariate and multivariable logistic regression analyses were used to assess factors associated with chronic kidney disease. Statistical significance was determined by p-value less than 0.05. Result:The overall prevalence of chronic kidney disease among study participants was17.5% (40/228) (95% CI: 12.8%-23.1%). The most frequently observed stage of chronic kidney disease was stage 3A, with a prevalence of 5.7% (13/228), followed by stage 1, which had a prevalence of 3.9%(9/228). Older age [AOR: 3.6, 95%CI: 1.08-11.96, p = 0.036] and family history of kidney disease [AOR: 2.9, 95%CI: 1.27-7.04, p = 0.012] were significantly associated with chronic kidney disease. Conclusion and recommendations: This study revealed thatapproximately one in six human immunodeficiency virus patients receiving highly active antiretroviral therapy were diagnosed with chronic kidney disease. Older age and having a family history of renal diseaseshowed a significant association with the development of chronic kidney disease.Therefore, it is important to regularly monitor kidney function in older individuals and those with a family history of renal disease in order to promptly identify and effectively manage chronic kidney disease in individuals on HAART.