article · PLOS Global Public Health
Widespread access to antiretroviral therapy has extended the lifespan of people living with HIV in sub-Saharan Africa, leading to an increased burden of non-communicable conditions like kidney dysfunction. In a cross-sectional study of 358 adult HIV clinic patients at Temeke Regional Referral Hospital in Dar es Salaam, renal function was evaluated using serum creatinine and estimated glomerular filtration rate. Kidney dysfunction was detected in 15.6 percent of participants, yet only 5.3 percent of those with reduced kidney function had previously been diagnosed. Additionally, nearly a quarter of the participants reported having at least one comorbid condition. Multivariable analysis showed that having comorbidities was the sole independent predictor of kidney dysfunction, raising the odds nearly fourfold. These findings highlight kidney dysfunction as a common, underdiagnosed comorbidity in this population, pointing to a need for integrating non-communicable disease screening into routine HIV care.
As individuals living with HIV survive longer due to effective treatment, managing concurrent chronic illnesses becomes vital. This research demonstrates that kidney impairment is both frequent and largely undetected among patients in urban Tanzania. Recognising the role of comorbidities helps healthcare systems prioritise targeted screening, allowing clinicians to identify renal problems early and prevent irreversible organ damage.
The findings support the clinical case for integrated chronic disease screening services and point-of-care diagnostics in HIV care settings. Potential end users include public healthcare clinics, diagnostic service providers, and HIV programme managers. However, as an observational prevalence study, the abstract does not indicate a direct commercial application pathway or product development timeline.
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As people living with HIV (PLHIV) in sub-Saharan Africa live longer due to widespread access to antiretroviral therapy (ART), the burden of non-communicable diseases, including kidney dysfunction (KD) has increased. Existing studies in Tanzania show varying prevalence and inconsistent predictors of KD, highlighting the need for updated, context-specific data. We conducted a cross-sectional sub-analysis of data from a larger study assessing point-of-care creatinine testing. PLHIV aged ≥18 years attending the HIV clinic at Temeke Regional Referral Hospital (TRRH) in Dar es Salaam from 5th January to 30th March 2025 consented to participate were included. Renal function was assessed using serum creatinine measured via the Jaffé method, and eGFR was calculated using the CKD-EPI 2021 equation. Kidney dysfunction was defined as eGFR < 60 mL/min/1.73 m². Logistic regression was used to identify predictors. Ethical approval was obtained from National Institute for Medical Research (NIMR) under reference number NIMR/HQ/R.8a/Vol.IX/4695. Among 358 participants, the majority were female (66.2%) and aged ≥45 years (62.3%). The prevalence of KD was 15.6% with 24.6% reporting at least one comorbid condition. In multivariable analysis, the presence of comorbidities was the only independent predictor of KD (aOR: 3.93; 95% CI: 1.85-8.36; p < 0.001). Only 5.3% of participants with reduced eGFR had a prior diagnosis of kidney disease. Kidney dysfunction is a significant but underdiagnosed comorbidity among PLHIV in urban Tanzania. Comorbid conditions, especially hypertension, are major contributors to reduced kidney function and integrating non-communicable disease screening and management into HIV care is needed to enable earlier detection and improve long-term renal outcomes.
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DOI: 10.1371/journal.pgph.0005011
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