title: Prevalence of chronic kidney disease among people living with HIV/AIDS in Burundi: a cross-sectional study.
abstract: BACKGROUND
  Since little is known about chronic kidney disease (CKD) among people living with HIV/AIDS (PLWHA) in Sub-Saharan Africa, the prevalence and nature of CKD were assessed in Burundi through a multicenter cross-sectional study.
  
  
  METHODS
  Patients underwent assessments at baseline and 3 months later. Glomerular Filtration Rate (GFR) was estimated using abbreviated 4-variable Modification of Diet in Renal Diseases (MDRD) and Cockroft-Gault estimation methods. Patients were classified at month 3 into various CKD stages using the National Kidney Foundation (NKF) definition, which combines GFR and urinary abnormalities. Risk factors for presence of proteinuria (PRO) and aseptic leukocyturia (LEU) were further analyzed using multiple logistic regression.
  
  
  RESULTS
  Median age of the patients in the study (N = 300) was 40 years, 70.3% were female and 71.7% were on highly active antiretroviral therapy. Using the MDRD method, CKD prevalence in patients was 45.7%, 30.2% of whom being classified as stage 1 according to the NKF classification, 13.5% as stage 2 and 2% as stage 3. No patient was classified as stage 4 or 5. Among CKD patients with urinary abnormality, PRO accounted for 6.1% and LEU for 18.4%. Significant associations were found between LEU and non-steroidal anti-inflammatory drug (NSAID) use, previous history of tuberculosis, low body mass index and female gender and between PRO and high viral load.
  
  
  CONCLUSIONS
  Our study, using a very sensitive definition for CKD evaluation, suggests a potentially high prevalence of CKD among PLWHA in Burundi. Patients should be regularly monitored and preventative measures implemented, such as monitoring NSAID use and adjustment of drug dosages according to body weight. Urine dipsticks could be used as a screening tool to detect patients at risk of renal impairment.
authors.affiliation: Infectious and tropical diseases department, Avicenne Hospital-APHP and Paris 13 University, 125 Route de Stalingrad, 93009, Bobigny, France. johann.cailhol@gmail.com
authors.forename: Johann
authors.initials: J
authors.lastname: Cailhol
authors.forename: Béatrice
authors.initials: B
authors.lastname: Nkurunziza
authors.forename: Hassan
authors.initials: H
authors.lastname: Izzedine
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Nindagiye
authors.forename: Laurence
authors.initials: L
authors.lastname: Munyana
authors.forename: Evelyne
authors.initials: E
authors.lastname: Baramperanye
authors.forename: Janvière
authors.initials: J
authors.lastname: Nzorijana
authors.forename: Désiré
authors.initials: D
authors.lastname: Sakubu
authors.forename: Théodore
authors.initials: T
authors.lastname: Niyongabo
authors.forename: Olivier
authors.initials: O
authors.lastname: Bouchaud
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000208:ethnology*; D000328:Adult; D002063:Burundi / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000208:ethnology; D015497:HIV-1; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence