title: Prevalence and Factors Associated with Renal Dysfunction in HIV Positive and Negative Adults at the University Teaching Hospital, in Lusaka.
abstract: BACKGROUND
  Despite having the highest disease burden of HIV, Sub-Saharan Africa has limited data on HIV related kidney disease with most available data coming from the developed countries. Kidney disease is a recognised complication in HIV infected patients presenting with acute renal failure (ARF) or chronic kidney disease (CKD). This study investigated the prevalence and risk factors associated with renal dysfunction among hospitalised HIV infected patients at the University Teaching Hospital (UTH), Lusaka.
  
  
  METHODS
  We conducted a cross sectional study at the University Teaching Hospital Lusaka, in Zambia. Inclusion criteria were hospitalised patients aged 16years and above who consented to the study. Both HIV infected and uninfected patients were included in the study. After obtaining demographic information, study participants were screened for HIV upon their consenting for the test. A full clinical history and examination was done by study physician to determine factors associated with renal dysfunction.
  
  
  RESULTS
  Of the 300 recruited hospitalised patients in this cross sectional study, 142(47%) were HIV infected. We observed a high prevalence of renal dysfunction among hospitalised HIV infected patients compared to uninfected patients (42% vs. 27%, adjusted OR 1.99, 95% CI 1.20-3.28). They had a twofold increased likelihood of developing kidney dysfunction (OR 1.96,95 CI%; 1.21-3.17). The presence of vomiting was strongly associated with renal dysfunction in both HIV positive (AOR 7.77, 95% CI 2.46-24-53) and negative (AOR4.83, 95%CI 1.40-16.66) subgroups. WHO stage III was associated with renal dysfunction in HIV infected patients. Tenofovir use, (a first line antiretroviral drug in Zambia) and hypotension were not significant factors associated with kidney disease after adjusting for other clinical parameters.
  
  
  CONCLUSIONS
  Renal dysfunction is significantly higher among hospitalised HIV infected compared to uninfected, however tenofovir and hypotension were not associated with renal dysfunction.
authors.affiliation: School of Medicine, University of Zambia, Lusaka Zambia.
authors.forename: Justor
authors.initials: J
authors.lastname: Banda
authors.affiliation: Department of Medicine, University Teaching Hospital, Lusaka, Zambia.
authors.forename: Aggrey
authors.initials: A
authors.lastname: Mweemba
authors.affiliation: Department of Public Health, University of Zambia.
authors.forename: Seter
authors.initials: S
authors.lastname: Siziya
authors.affiliation: Department of Medicine, University Teaching Hospital, Lusaka, Zambia.
authors.forename: Morgan
authors.initials: M
authors.lastname: Mweene
authors.affiliation: School of Medicine, University of Zambia, Lusaka Zambia ; Vanderbilt Universities, Nashville, TN, USA.
authors.forename: Ben
authors.initials: B
authors.lastname: Andrews
authors.affiliation: Department of Medicine, University Teaching Hospital, Lusaka, Zambia.
authors.forename: Shabir
authors.initials: S
authors.lastname: Lakhi