Renal Function Impairment and Associated Factors Among Adult HIV-Positive Patients Attending Antiretroviral Therapy Clinic in Mettu Karl Referral Hospital: Cross-Sectional Study

Bilisumamulifna Tefera Kefeni,1 Kifle Woldemichael Hajito,2 Masrie Getnet2 1Department of Public Health, College of Health Sciences, Mettu University, Mettu, Ethiopia; 2Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, Jimma University, Jimma, EthiopiaCorrespondence: Bilisumamulifna Tefera Kefeni Tel +251-911-537-978Email bilisumamulifna430@gmail.comBackground: Human immunodeficiency virus (HIV) affects every organ system in the body through impairment or by rendering the patient vulnerable to opportunistic infections. The kidney is the vital organ in the excretion of waste products and toxins (urea, creatinine and uric acid), and regulation of extracellular fluid volume, serum osmolality and electrolyte concentrations. The risk of kidney disease is greater in HIV-infected individuals than in the general population. This study aimed to assess the magnitude of renal function impairment and its associated factors among adult HIV-positive patients attending an ART clinic in Mettu Karl Referral Hospital, Mettu town, south-west Ethiopia.Methods: The institution-based, cross-sectional quantitative study was conducted from March 8 to May 30, 2020. A total of 352 clients participated and a systematic sampling technique was used to allocate study participants. Data were entered into Epi data and exported to SPSS version 22 for analysis. Bivariate analysis was conducted to identify candidate variables for multivariate analysis at P < 0.25. Multivariable logistic regression analysis was conducted to determine the predictors of renal function impairment with ART. P value < 0.05 was considered to indicate statistical significance.Results: A total of 352 HIV-infected patients participated in this study with a response rate of 98.1%. Out of 352 HIV patients on ART, 73 (20.7%) were found to have renal function impairment. Cigarette smoking [AOR = 9.60, 95% CI: 4.73– 19.48], diabetes mellitus [AOR = 6.16, 95% CI: 2.79– 13.59], hypertension [AOR = 4.71, 95% CI: 1.98– 11.17] and low CD4 count [AOR = 6.47, 95% CI: 3.31– 12.64] were found to be independent predictors of renal function impairment among adult HIV positive patients.Conclusion: The prevalence of renal function impairment among HIV patients on ART is high. Hypertension, diabetes, cigarette smoking and low CD4 count were associated factors of renal function impairment. HIV patients on ART should be regularly screened for early diagnosis and management of renal function impairment.Keywords: renal impairment, HIV positive, ART, Mettu