Cox regression of factors associated with the onset of chronic kidney disease in HIV/AIDS patients in Albert Luthuli Municipality of South Africa

Abstract Background: Current research indicates that chronic kidney disease is a global problem which poses a major health threat to people of poor countries with HIV/AIDS and on antiretroviral treatment. In this study, the prevalence of chronic kidney disease and the factors associated with it were investigated among the HIV/AIDS patients in a rural community of South Africa. Methods: A cohort of HIV+ terminal ill patients was retrospectively followed from 2010 to 2017 until chronic kidney disease was diagnosed or until the end of the observation period at two hospitals (Carolina and Embhuleni). Patient information was obtained from the routine hospitals’ records, and the data were analysed using Cox regression and survival analysis (Kaplan-Meier hazard functions and ratios, and log-rank tests) methods. Results: Out of a random sample of 320 HIV/AIDS patients, 51 patients (15.9%) had chronic kidney disease. The factors associated with chronic kidney disease were: Gender (p-value=0.0356), Age (p-value=0.00077), Baseline creatinine (p-value=0.00253), Follow-up alanine transaminase (p-value=0.0152), ART treatments (p-value<0.00193) and Hospital (p-value=0.00258). Discussion: Whilst antiretroviral treatment is associated with some improvement in virology and immunology in HIV-infected patients, research is still needed for the assessment of the impact of ART and other risk factors on renal function in marginalised communities in Africa. Conclusion: The research findings on HIV+ patients in Albert Luthuli Municipality concurred with several previous research findings on risk factors to CKD. The expected action to alleviate the health threat due to CKD in South Africa is to educate the nation on prevention, early detection and on the management of the disease.