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. 2024 Sep 27;25(1):321.
doi: 10.1186/s12882-024-03761-1.

Higher prevalence of kidney function impairment among older people living with HIV in Uganda

Amutuhaire Judith Ssemasaazi  1   2 , Robert Kalyesubula  3 , Yukari C Manabe  4   5 , Phoebe Mbabazi  4   6 , Susan Naikooba  4 , Faizo Ssekindi  4 , Esther Nasuuna  4 , Pauline Byakika-Kibwika  4   3 , Barbara Castelnuovo  4
Affiliations

Higher prevalence of kidney function impairment among older people living with HIV in Uganda

Amutuhaire Judith Ssemasaazi et al. BMC Nephrol. .

Abstract

Background: People living with HIV (PLWH) are at risk of kidney function impairment due to HIV-related inflammation, antiretroviral therapy (ART), diabetes mellitus, and hypertension. Older persons may experience a higher burden of chronic kidney disease (CKD) as kidney function declines with increasing age. There is a paucity of data comparing the prevalence of kidney function impairment in older PLWH to that in people without HIV in sub-Saharan Africa.

Methods: We conducted a cross-sectional study among people aged ≥ 60 years living with and without HIV in Kampala, Uganda who were matched 1:1 by community location. We collected data on sociodemographics, comorbidities, and HIV-related clinical characteristics. We defined kidney function impairment as an estimated glomerular filtration rate(eGFR) < 60mls/min/1.73m2 with or without proteinuria. We constructed multivariable logistic regression models to study associations between participant characteristics and kidney function impairment.

Results: We enrolled 278 people (median age 66 years); 50% were PLWH, and 51.8% were female. Among PLWH, 33.1% (95% CI: 25.7-41.4%) had kidney function impairment versus 12.9% (95% CI: 8.3-19.7%) among people without HIV, (p-value < 0.01). The prevalence of proteinuria among PLWH versus people without HIV was 43.9% (95% CI:35.8-52.3%) versus 19.4% (95% CI:13.6-26.9%) p-value < 0.01. Living with HIV (OR = 3.89(95% CI: 2.04-7.41), p-value < 0.01), older age (OR = 1.13, (95% CI:1.07-1.20), p-value < 0.01), female sex (OR = 1.95, (95% CI:1.06-3.62), p-value = 0.03) and a prior diagnosis of hypertension (OR = 2.19(95% CI:1.02-4.67), p-value = 0.04) were significantly associated with kidney function impairment.

Conclusions: HIV infection is strongly associated with kidney function impairment among older PLWH. Prioritizing routine measurements of kidney function and proteinuria in older PLWH will enable early detection and institution of measures to reduce the progression of kidney disease.

Keywords: Kidney function impairment; Older persons; Sub-saharan Africa.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Median estimated GFR of people aged ≥ 60 years living with and without HIV in Uganda
Fig. 2
Fig. 2
Prevalence of kidney function impairment among PLWH and people without HIV stratified by disease stage (GFR categories)
Fig. 3
Fig. 3
Prevalence of proteinuria among older people with and without HIV stratified by category of proteinuria
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