Chronic Kidney Disease among Ghanaian HIV Individuals on HAART in the Ho Municipality: A Single-Center Descriptive Cross-Sectional Study

Abstract

Background: Chronic kidney disease (CKD) remains one of the complications of HIV infection among individuals on antiretroviral medication. This study aimed to determine the prevalence of CKD among Ghanaians with HIV on antiretroviral medications at the Ho Municipal Hospital. Materials and Methods: This is a hospital-based cross-sectional study involving 170 previously diagnosed HIV-infected patients on HAART treatment at the ART Clinic of the Ho Municipal Hospital. The participants aged between 24 and 78 years were conveniently and purposively recruited into the study from February to May 2017. Using patients’ folders, data on patients’ age, gender, type of medication(s) and duration on HAART medication were obtained. Patients’ blood samples were obtained for the estimation of CD4 count and serum creatinine concentration. Estimated Glomerular Filtration Rate (eGFR) was calculated based on serum creatinine levels using the four-Variable Modification of Diet in Renal Disease (4v-MDRD) and the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equations. Results: The prevalence of CKD was estimated at 17.06% and 18.82% based on the 4v-MDRD and the CKD-EPI equations respectively. Females recorded a higher prevalence (20.00% and 22.14%) compared to their male counterparts (3.33% and 3.33%) using the 4v-MDRD and the CKD-EPI equations respectively. Low immunological recovery (CD4 cell count <500 cell/mm3) and longer duration on HAART (7-9 years) accounted for higher CKD prevalence. Conclusion: In these patients receiving HAART treatment at the Ho Municipal Hospital, a high burden of CKD was observed among the female group. HAART regimen containing concurrent Nevirapine and Tenofovir had the highest CKD among the participants.