Chronic kidney disease among children living with the human immunodeficiency virus in sub-Saharan Africa

Background: Chronic kidney disease (CKD) remains an important comorbid condition in people living with HIV. However, data in children living with HIV/AIDS (CLWHA) in sub-Saharan Africa is limited. We sought to establish the prevalence and identify risk factors of CKD among CLWHA in SSA.Methods: This was a retrospective chart review across five SSA countries HIV/AIDS care sites, March 2000 and June 2016.Results: 4,859 children with at least two clinic visits were enrolled in the study. The median age at the first clinic visit was 5.7 (IQR; 2.5, 9.5) years, and median follow-up time was 22.6 (IQR 9.8, 46.1) months. 11.2% CLWHA had an eGFR of < 60 mL/min/1.73m2 on at least one clinic visit. The prevalence of CKD was 1.6%. In a multivariable Poisson regression analysis, CKD was associated with severe immunosuppression, incident rate ratio (IRR) 2.69 (95% CI, 1.11, 6.51). Risk of CKD decreased with increasing age (IRR 0.51 (95% CI, 0.39, 0.67). There was no association between CKD and ART regimen.Conclusion: CKD was not as prevalent as previously reported in children in other studies. Kidney function moni-toring should be incorporated into the pediatric HIV care monitoring guidelines to allow for better evaluation of kidney disease in CLWHA.