Comparison of the prevalence and associated factors of chronic kidney disease diagnosed by serum creatinine or cystatin C among young people living with HIV in Uganda.

Autor:	Nasuuna EM; Non-communicable Diseases Program, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe Uganda.; Infectious Diseases Institute, Makerere University, College of Health Sciences, Kampala, Uganda., Tomlinson LA; Department of non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK., Kalyesubula R; Non-communicable Diseases Program, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe Uganda.; Departments of Physiology and Medicine, Makerere University College of Health Sciences, Kampala, Uganda., Chikwari CD; Biomedical Research and Training Institute, Harare, Zimbabwe.; MRC International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK., Castelnuovo B; Non-communicable Diseases Program, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe Uganda., Manabe YC; Infectious Diseases Institute, Makerere University, College of Health Sciences, Kampala, Uganda.; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Nakanjako D; Infectious Diseases Institute, Makerere University, College of Health Sciences, Kampala, Uganda.; Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda., Weiss HA; MRC International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK.
Jazyk:	angličtina
Zdroj:	MedRxiv : the preprint server for health sciences [medRxiv] 2024 Sep 03. Date of Electronic Publication: 2024 Sep 03.
DOI:	10.1101/2024.09.02.24312932
Abstrakt:	Introduction: Young people living with HIV (YPLHIV) are at increased risk of developing chronic kidney disease (CKD) which is associated with high mortality and morbidity. Early diagnosis is important to halt progression. We aimed to estimate the prevalence and factors associated with CKD among YPLHIV in Kampala, Uganda, and to compare serum creatinine and cystatin C for early diagnosis of CKD in this population. Methods: A cross-sectional study with YPLHIV aged 10 to 24 years was conducted in seven HIV clinics. Participants provided a urine and blood sample to measure urinary albumin, proteinuria, serum creatinine and cystatin C levels at baseline and after three months. The estimated glomerular filtration rate (eGFR) was calculated using CKDEPI 2021, Cockroft-Gault and bedside Schwartz equations using creatinine or cystatin C. The albumin creatinine ratio (ACR) and proteinuria were measured. CKD was defined as either eGFR <60ml/min/1.73m 2 or <90ml/min/1.73m 2 or ACR above 30mg/g on two separate occasions. Univariable and multivariable logistic regression were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for factors associated with CKD. Results: A total of 500 participants were enrolled. Most were female (56%; n=280) and aged 10 to 17 years (66.9%; n=335). CKD prevalence ranged from 0-23% depending on the criteria, equation and biomarker used. Cystatin C-based equations estimated higher prevalence of CKD compared to creatinine-based ones. Prevalence of ACR above 30mg/g was 10.1% and of proteinuria 29%. Factors independently associated with CKD were age (aOR=1.42; 95% CI:1.30-1.51) and male sex (aOR=3.02; 95% CI:1.68-5.43). Conclusion: CKD prevalence among YPLHIV varied substantially depending on definitions used and the current definition would likely lead to missed cases of CKD among YPLHIV. Estimating equations should be validated against measured GFR in YPLHIV and the optimal definition of CKD in this vulnerable population should be revised to optimise detection and opportunities for reducing disease progression. Competing Interests: Competing interests The authors declare no conflict of interest.
Databáze:	MEDLINE
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