title: Prevalence of kidney disease in HIV-infected and uninfected Rwandan women.
abstract: BACKGROUND
  In the United States, HIV-related kidney disease disproportionately affects individuals of African descent; however, there are few estimates of kidney disease prevalence in Africa. We evaluated the prevalence of kidney disease among HIV-infected and uninfected Rwandan women.
  
  
  METHODS
  The Rwandan Women's Interassociation Study and Assessment prospectively enrolled 936 women. Associations with estimated glomerular filtration rate (eGFR)<60 mL/min/1.73 m(2) and proteinuria were assessed in separate logistic regression models.
  
  
  RESULTS
  Among 891 non-pregnant women with available data, 2.4% had an eGFR<60 mL/min/1.73 m(2) (calculated by the Modification of Diet in Renal Disease equation, MDRD eGFR) and 8.7% had proteinuria ≥1+. The prevalence of decreased eGFR varied markedly depending on the estimating method used, with the highest prevalence by Cockcroft-Gault. Regardless of the method used to estimate GFR, the proportion with decreased eGFR or proteinuria did not differ significantly between HIV-infected and -uninfected women in unadjusted analysis. After adjusting for age and blood pressure, HIV infection was associated with significantly higher odds of decreased MDRD eGFR but not proteinuria.
  
  
  CONCLUSIONS
  In a well-characterized cohort of Rwandan women, HIV infection was associated with decreased MDRD eGFR. The prevalence of decreased eGFR among HIV-infected women in our study was lower than that previously reported in African-Americans and in other Central and East African HIV populations, although there was substantial variability depending on the equation used to estimate GFR. Future studies are needed to optimize GFR estimates and to determine the impact of antiretroviral therapy on kidney disease in this population.
authors.affiliation: Mount Sinai School of Medicine, New York, New York, United States of America.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Wyatt
authors.forename: Qiuhu
authors.initials: Q
authors.lastname: Shi
authors.forename: James E
authors.initials: JE
authors.lastname: Novak
authors.forename: Donald R
authors.initials: DR
authors.lastname: Hoover
authors.forename: Lynda
authors.initials: L
authors.lastname: Szczech
authors.forename: Jules Semahore
authors.initials: JS
authors.lastname: Mugabo
authors.forename: Agnes
authors.initials: A
authors.lastname: Binagwaho
authors.forename: Mardge
authors.initials: M
authors.lastname: Cohen
authors.forename: Eugene
authors.initials: E
authors.lastname: Mutimura
authors.forename: Kathryn
authors.initials: K
authors.lastname: Anastos
mesh_terms: D000328:Adult; D003710:Demography; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000453:epidemiology* / Q000503:physiopathology; D015999:Multivariate Analysis; D015995:Prevalence; D012432:Rwanda / Q000453:epidemiology