Prevalence and predictors of kidney dysfunction among people living with HIV in Tanzania

As people living with HIV (PLHIV) in sub-Saharan Africa live longer due to widespread access to antiretroviral therapy (ART), the burden of non-communicable diseases, including kidney dysfunction (KD) has increased. Existing studies in Tanzania show varying prevalence and inconsistent predictors of KD, highlighting the need for updated, context-specific data. We conducted a cross-sectional sub-analysis of data from a larger study assessing point-of-care creatinine testing. PLHIV aged ≥18 years attending the HIV clinic at Temeke Regional Referral Hospital (TRRH) in Dar es Salaam from 5th January to 30th March 2025 consented to participate were included. Renal function was assessed using serum creatinine measured via the Jaffé method, and eGFR was calculated using the CKD-EPI 2021 equation. Kidney dysfunction was defined as eGFR < 60 mL/min/1.73 m². Logistic regression was used to identify predictors. Ethical approval was obtained from National Institute for Medical Research (NIMR) under reference number NIMR/HQ/R.8a/Vol.IX/4695. Among 358 participants, the majority were female (66.2%) and aged ≥45 years (62.3%). The prevalence of KD was 15.6% with 24.6% reporting at least one comorbid condition. In multivariable analysis, the presence of comorbidities was the only independent predictor of KD (aOR: 3.93; 95% CI: 1.85-8.36; p < 0.001). Only 5.3% of participants with reduced eGFR had a prior diagnosis of kidney disease. Kidney dysfunction is a significant but underdiagnosed comorbidity among PLHIV in urban Tanzania. Comorbid conditions, especially hypertension, are major contributors to reduced kidney function and integrating non-communicable disease screening and management into HIV care is needed to enable earlier detection and improve long-term renal outcomes.