{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T03:40:11Z","timestamp":1767066011748,"version":"3.48.0"},"reference-count":55,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,6,13]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"\n Objective<\/jats:title>\n To assess the incidence, progression and predictors of chronic kidney disease among adult patients living with HIV\/AIDS who are receiving antiretroviral therapy.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n An institution-based, multicentre retrospective follow-up study was conducted among a randomly selected sample of 535 adult patients. Data were entered into Epi Data version 4.6.0 and analysed using STATA version 14.0. A Cox proportional hazards regression model was fitted to identify independent predictors of chronic kidney disease incidence. Variables with p<0.05 in the multivariable model were considered statistically significant.<\/jats:p>\n <\/jats:sec>\n \n Setting and participants<\/jats:title>\n The study was conducted at comprehensive specialised hospitals in the Amhara Region of Ethiopia. Adult patients with HIV\/AIDS receiving follow-up antiretroviral therapy between 1 April 2012 and 31 September 2022 were the cohort participants.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of the 528 adult patients included in the final analysis, 15 (2.84%) developed chronic kidney disease during the follow-up period, resulting in an overall incidence rate of 4.1 per 1000 person-years of observation. Significant predictors of chronic kidney disease included baseline age (adjusted HR (AHR)=1.053; 95%\u2009CI, 1.001 to 1.108), serum creatinine (AHR=1.698; 95%\u2009CI, 1.302 to 2.215), blood urea nitrogen (AHR=1.031; 95%\u2009CI, 1.001 to 1.061) and baseline viral load \u22651000 copies\/mL (AHR=3.464; 95%\u2009CI, 1.104 to 10.871).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The incidence of chronic kidney disease among adult patients with HIV was clinically significant. Older age, baseline viral load \u22651000 and high blood urea nitrogen and creatinine levels were significant predictors of higher risk. Proactive measures, such as closer kidney monitoring, targeted care for older patients and ensuring optimal viral suppression with effective antiretroviral therapy, can delay or prevent the development of chronic kidney disease.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-090345","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T16:30:46Z","timestamp":1752510646000},"page":"e090345","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Incidence, progression and predictors of chronic kidney disease among adult HIV\/AIDS patients on antiretroviral treatment in comprehensive specialised hospitals in the Amhara Region, Ethiopia, 2022: a multi-centre retrospective follow-up study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5372-3550","authenticated-orcid":false,"given":"Melsew Dagne","family":"Abate","sequence":"first","affiliation":[{"name":"Department of Adult Health Nursing, Injibara University, Injibara, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mulat Awoke","family":"Kassa","sequence":"additional","affiliation":[{"name":"Department of Nursing, Woldia University, Woldia, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gizachew","family":"Yilak","sequence":"additional","affiliation":[{"name":"Department of Nursing, Woldia University, Woldia, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7943-3280","authenticated-orcid":false,"given":"Tesfaye Engdaw","family":"Habtie","sequence":"additional","affiliation":[{"name":"Department of Adult Health Nursing, Woldia University, Woldia, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dessie","family":"Temesgen","sequence":"additional","affiliation":[{"name":"Department of Nursing, Woldia University, Woldia, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berihun","family":"Mulu","sequence":"additional","affiliation":[{"name":"Department of Public Health, Woldia University, Woldia, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3051-1296","authenticated-orcid":false,"given":"Sefineh Fenta","family":"Feleke","sequence":"additional","affiliation":[{"name":"Department of Public Health, Woldia University, Woldia, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amsalu","family":"Baylie","sequence":"additional","affiliation":[{"name":"Department of Nursing, Woldia University, Woldia, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9902-7921","authenticated-orcid":false,"given":"Molla Azmeraw","family":"Bizuayehu","sequence":"additional","affiliation":[{"name":"Department of Nursing, Woldia University, Woldia, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"key":"2025121411303010000_15.7.e090345.1","doi-asserted-by":"publisher","DOI":"10.1038\/kisup.2012.73"},{"key":"2025121411303010000_15.7.e090345.2","doi-asserted-by":"crossref","DOI":"10.1186\/s12882-021-02597-3","article-title":"Burden of chronic kidney disease and its risk-attributable burden in 137 low-and middle-income countries, 1990-2019: results from the global burden of disease study 2019","volume":"23","author":"Ke","year":"2022","journal-title":"BMC Nephrol"},{"key":"2025121411303010000_15.7.e090345.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2017-000380","article-title":"Chronic kidney disease and the global NCDs agenda","volume":"2","author":"Neuen","year":"2017","journal-title":"BMJ Glob Health"},{"key":"2025121411303010000_15.7.e090345.4","unstructured":"CDC . 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