Objective: Cardiovascular-kidney- metabolic syndrome (CKM) describes the interaction between metabolic risk factors such as central obesity and/or diabetes mellitus and hypertension, chronic kidney disease and cardiovascular disease. Our study aims to compare the prevalence of early, intervention-accessible stages of CKM in HIV infected and non-infected individuals in an urban cohort in Zambia. Design and method: After receiving medical information and providing written consent, patients of both sexes (aged above 18 years) who presented at four health centres on site underwent standardised examinations. Anthropometric data, medical history and medication information were documented, and blood samples were taken to determine kidney and metabolic parameters. Metabolic syndrome was diagnosed in the presence of three out of five risk factors according to the 2009 consensus publication (waist circumference of >=97/92 cm (men/women) for sub-Saharan Africa). For CKM stage 2, diabetes mellitus, triglycerides >=135 mg/dl and a glomerular filtration rate (eGFR according to the CKD-EPI formula) =140/90 mmHg from the last 2 of 3 measurements at rest (oscillometric while seated). Results: Data from 633 participants (mean age 36.6±14 years, 368 women, 58.1%), including 194 (30.6%) PLHIV, were analysed. The most common risk factor in both sexes was reduced kidney function <60 ml/min/1.73m2 (29.6% women vs. 18.3% men). A CKM stage 2 was present in a total of 60.1% of HIV-negative participants, compared to 76.3% in PLHIV (p<0.001, see table). Treated and controlled hypertension (<140/90) was found in a total of 26/60 women (43.3%) and 7/17 men (41.2%).Conclusions: A cluster of cardio-metabolic risk factors was detected in approximately 75% of PLHIV. Systematic blood pressure monitoring combined with kidney function tests as well as integrated patient education, training and treatment programmes into existing HIV health centres could lead to a reduction in cardiovascular and renal end-organ damage in regions such as Zambia.
Vadokas et al. (Fri,) studied this question.