INTRODUCTION: The incidence and risk factors of tenofovir disoproxil fumarate (TDF) -related renal impairment (RI) in Namibia are unknown where TDF-containing ART regimens are used as the first line for HIV .
METHODOLOGY: A retrospective cohort study among HIV-infected patients at two intermediate hospitals . A decline in estimated glomerular filtration rate (eGFR) was significant if it was ≥25% and included a change to a lower eGFR stage . New-onset RI was defined as an eGFR <50 mL/min/1.73m2 .
RESULTS: 10 387 patients were included: 11.4% (n = 1182) experienced the decline in eGFR . Of these , 0.6% (n = 62) migrated to eGFR stages IV and V. The incidence was 4.5 (95% CI : 4.3-4.8) per 100 patient years . RI developed in 400 patients for an incidence rate of 2.4 (95% CI : 2.2-2.6) cases per 100 patient years . Risk factors with effect sizes> 2.0, for decline-in-eGFR were baseline eGFR> 60 (aHR = 15.6); hyperfiltration (aHR = 5.0); and pregnancy (aHR = 2.4); while for RI, they were hyperfiltration (aHR = 4.1) and pregnancy (aHR = 29).
CONCLUSION: The incidence of decline-in-eGFR was higher than in other sub-SSA countries, but not RI . A high baseline eGFR had the greatest risk for the decline, and hyperfiltration for the RI.