Abstract

Background: Chronic kidney disease (CKD) has recently posed a significant public health concern in lower-middle-income countries, including Lesotho. Despite comorbidities such as diabetes mellitus (DM), hypertension (HTN), and Human Immunodeficiency Virus (HIV) worsening the condition, the combined impact on Chronic kidney disease prognosis is not well understood in Lesotho.
Objective: The study aimed to assess the prognosis of chronic kidney disease in individuals living with Human Immunodeficiency Virus, co-morbid hypertension, and diabetes mellitus, in two clinics in Maseru.
Method: This retrospective cross-sectional study was conducted at the Lesotho Defence Force (LDF) and Domiciliary clinics using medical records in adult patients living with HIV, comorbid hypertension and/or diabetes mellitus. The data was analysed with IBM SPSS version 20. The descriptive data were presented as frequencies and percentages, while the continuous data were presented as means and standard deviations.
Results: At the LDF clinic, 53.1% of the patients were female, and 46.9% were male. Patients living with HIV were diagnosed with CKD stage 2, those with HIV and HTN had CKD stage 3a, and those with HIV, HTN, and DM had CKD stage 3b. At the Domiciliary clinic, 56.7% of the were female, and 43.1% (56) were male. Patients with HIV and HTN had CKD 2, and CKD 3a for patients with all three comorbidities.
Conclusion: Both CKD-EPI and MDRD methods showed minimal differences in eGFR. The CKD-EPI formula in HIV-comorbid hypertensive and/or diabetic patients defines stage 3 renal failure earlier. HIV, HTN, and DM were the major risk factors for poor CKD prognosis, often leading to kidney failure.

Keywords: Comorbidity; Prognosis; Chronic Kidney Disease; CKD-EPI; MDRD