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 5 th January to 30 th 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.