Prevalence and Factors Associated with Renal Disease Among HIV Infected Children on Antiretroviral Therapy Attending Joint Clinical Research Center, Lubowa, Kampala

Introduction Renal disease is asymptomatic in its early stages but on progression into advanced stage is expensive to manage requiring renal replacement therapy. Monitoring of children’s renal functionality is not routinely done but only on a doctor’s request. However, there is currently no published study on renal disease prevalence among children living with HIV in Uganda and the associated factors. Objective To determine the prevalence of renal disease and its associated factors among HIV positive children on ART at the Joint Clinical Research Center (JCRC) Pediatric clinic. Methods We conducted a cross sectional study from JCRC Pediatrics Clinic. Children attending the clinic between January and August, 2020 were recruited using consecutive sampling. Information on age, sex, z sore for age, Blood pressure, route of transmission, clinical stage of the disease, ART regimen, duration on ART, non-ART drugs, Viral load and comorbidities was obtained. Blood and urine samples were also collected from the participants and sent to the laboratory for analysis. Renal disease was diagnosed using either proteinuria on urine dipstick or reduced estimated Glomerular Filtration Rate, (eGFR). Results The study participants were 261, of which 51% were female and 49% male, with a median age of 12 years. The prevalence of renal diseases was 21.5% as proteinuria and 9.6% with low eGFR. Factors associated with proteinuria were; age (p-value =0.01), clinical stage of the disease (p=0.035) and diastolic blood pressure (DBP, p = 0.001) and with low eGFR were; DBP (p < 0.001) and clinical stage of disease (p < 0.001). Conclusion The prevalence of proteinuria was high (21.5%) and that of low eGFR was (9.1%). Early screening for renal disease when still asymptomatic as a preventive strategy for renal disease should be considered, especially using affordable yet effective methods like urinalysis. This is because all the participants were asymptomatic at the time of enrollment.