Impaired Renal Function and Associated Factors Among HIV-Infected Individuals Who Are on Follow-Up in Two Tertiary Hospitals’ Art Clinic, Addis Ababa, Ethiopia

Abstract

Background: It has been four decades since the Human Immunodeficiency Virus (HIV) became a global public health issue; much has changed about the disease since then. The occurrence of renal impairment in HIV-infected individuals is associated with both increased morbidity and mortality. Objective: The goal of this study was to assess the incidence of renal dysfunction and the variables associated with it in HIV-positive patients undergoing treatment at the ART clinics of Zewuditu Memorial Hospital (ZMH) and St. Paul's Millennium Medical College (SPHMMC) between April and August of 2021. Methodology: A cross-sectional study was conducted to assess the association between impaired renal function and different factors among HIV-infected individuals. Data was collected from the medical charts of the patients in the anti-retroviral therapy (ART) clinic of respective hospitals. Variables with a p-value of <0.25 on bivariate analysis were taken to Multivariable logistic regression to see the statistical significance and at <0.05 statistical significance was declared. Result: The total number of samples was 405, and all of them were included in the analysis. The magnitude of the renal dysfunction revealed in this study was 8.4% (95% Confidence Interval: 5.51 to 11.4). Multivariable logistic regression showed that being female (Adjusted Odds Ratio = 4.5; 95%CI: 1.94, 10.36), Baseline CD4 count less than 200, (AOR = 3.4; 95% CI:1.34, 8.70), and a history of opportunistic infection (AOR = 2.7; 95% CI: 1.02, 7.39) were significantly associated with the impaired renal function. Conclusion: Routine monitoring of renal function, especially in patients with risk factors like female gender, low CD4 count, and history of opportunistic infections, is crucial. Promoting ART regimens containing TDF, early detection and prevention of opportunistic infections, and educating patients about regular CD4 count monitoring and timely treatment are essential for maintaining renal health.