588. ART – induced nephrotoxicity and Chronic Kidney Diseases among ambulatory HIV – infected patients with low Body Mass Index in Brazzaville, Congo: incidence and associated risk factors.
Session: Poster Abstract Session: HIV: Kidney, Bone + Liver Effects
Thursday, October 5, 2017
Room: Poster Hall CD
Background: To describe the incidence and risks factors of ART induced nephrotoxicity and chronic kidney disease (CKD) in HIV-1-infected adults with low body mass index (< 18.5kg/m2).

Methods: A retrospective cohort study at the Ambulatory Treatment Center in Brazzaville, Congo. Patients with estimated glomerular filtration rate (eGFR) decrease by 25% compared to baseline or a 0.5mg/dL increase in Serum creatinine (Scr) above baseline were classified as having nephrotoxicity, and CKD was defined as a value less than 60 ml/min per 1.73m2 .We used Cox proportional hazards regression models to determine factors associated with nephrotoxicity and CKD.

Results: Of 325 patients, 73.23 % were women. Median values was: age: 37.55years (IQR: 33.51 – 44.96), weight: 45kg (IQR: 41 – 49), CD4 count: 137.5 cells/µl (42 – 245). In the first 24 – months followup on ART incidence rate of nephrotoxicity and CKD was 27.95 and 7.44 per 100 person – years respectively. Multivariate analysis identified as a risk factor of nephrotoxicity, baseline haemoglobin below or equal 8 g/dL (aHR=2.25; 95% CI, 1.28 – 3.98; p=0.005), eGFR between 60 – 80 (aHR=0.34 ; 95%CI, 0.20 – 0.57; p<0.001) and 45 – 59 ml/min/1.73m2 (aHR=0.09 ; 95%CI, 0.01 – 0.68; p=0.02), and the use of tenofovir (aHR=1.51; 95%CI, 1.01 – 2.27; p=0.04). Each 10-year older age was associated with an increased risk of developing CKD (aHR=1.95; 95%CI, 1.2 – 3.17; p=0.007).

 Conclusion: Incidence of nephrotoxicity and CKD were high. African HIV positive patient with low BMI at baseline need close monitoring of their renal function when treated with tenofovir.

Martin Herbas Ekat, M.D., Ministry of Health, Ambulatory Treatment Center of Brazzaville, Brazzaville, Congo-Brazzaville and Cheikh Tidiane Ekat, MD, Cheikh Anta Diop University, Dakar, Senegal


M. H. Ekat, None

C. T. Ekat, None

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