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P2.28 Art – induced nephrotoxicity and chronic kidney diseases among ambulatory hiv – infected patients with low body mass index in brazzaville, congo: incidence and associated risk factors
  1. Martin Herbas Ekat
  1. University Hospital of Brazzaville

Abstract

Introduction To describe the incidence and risks factors of ART induced nephrotoxicity and chronic kidney disease (CKD) in HIV-1-infected adults with low body mass index (<18.5kg/m2).

Methods A retrospective cohort study at the Ambulatory Treatment Centre in Brazzaville, Congo. Patients with estimated glomerular filtration rate (eGFR) decrease by 25% compared to baseline or a 0.5 mg/dL increase in Serum creatinine (Scr) above baseline were classified as having nephrotoxicity, and CKD was defined as a value less than 60 ml/min per 1.73m².We used Cox proportional hazards regression models to determine factors associated with nephrotoxicity and CKD.

Results Of 325 patients, 73.23% were women. Median values was: age: 37.55 years (IQR: 33.51–44.96), weight: 45 kg (IQR: 41–49), CD4 count: 137.5 cells/µl (42 – 245). In the first 24 – months followup on ART incidence rate of nephrotoxicity and CKD was 27.95 and 7.44 per 100 person – years respectively. Multivariate analysis identified as a risk factor of nephrotoxicity, baseline haemoglobin below or equal 8 g/dL (aHR=2.25; 95% CI, 1.28–3.98; p=0.005), eGFR between 60–80 (aHR=0.33; 95% CI, 0.20–0.56; p=0.001) and below 60 ml/min/1.73m2 (aHR=0.11; 95% CI, 0.03–0.46; p=0.003), and the use of tenofovir (aHR=1.51; 95% CI, 1.01–2.26; p=0.04). Each 10 year older age was associated with an increased risk of developing CKD (aHR=1.95; 95% CI, 1.2–3.17; p=0.007).

Conclusion Incidence of nephrotoxicity and CKD were high. HIV positive patient with low BMI at baseline need close monitoring of their renal function when treated with tenofovir.

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