Assessment of the Effects of Antiretroviral Medications on Kidney Status in Rwanda

Abstract

According to the previous research, ART over different durations of time has an effect on the nephron as well as on liver hepatoxicity by inducing toxicity. Renal dysfunction by ART has been associated primarily with tenofovir disoproxil, which is actively accumulated in the proximal renal tubule. CKD is the major problem in ART patients and can lead to loss of kidney function, leading to complications and kidney failure, and development of cardiovascular disease. The main objectives of this study was to assess the effect of antiretroviral drugs on kidney function among the patients attended Nyanza DH during the period of two years. The research is retrospective study done to identify the effect of antiretroviral drugs on kidney Status in Nyanza DH. In total, 755 patients received the antiretroviral medications in Nyanza DH during a period of two years from the 1st of January 2015 to the 31st of December 2017. However 98 patients had data complying with the objective of this study. Those patients with kidney tests conducted every 6months, with elevated CD4 count, and eliminated viral charge. Furthermore nephrotoxicity incidence was considered for both higher concentration of Serum creatinine and lower creatinine Clearance. The results showed that among 98 patients, 24.4% had kidney dysfunction characterized by elevated serum creatinine level at the beginning of treatment. After 6, 12 and 18 months of treatment the percentages of patients with elevated serum creatinine increased to 41.8%, 48.9 % and 50% respectively. It was found that the severity of the problem depends on: combinations the patient is taking, duration of exposure, and other medications the patient is using in combination. In this context it was found that 96.7% of patients that developed nephrotoxicity after 18months were using TDF .The results showed a higher frequency of nephrotoxicity in the population of the study. Therefore, a systematic kidney function monitoring from the beginning of the treatment should be of a great importance, those test could help to take appropriate measures.