Abstract
We conducted an observational cohort study of end-stage kidney disease (ESKD) in >7000 African and Caribbean people with HIV in the UK. Using Poisson regression and East Africans as the reference group, the adjusted incidence rate ratio (95% confidence interval) of ESKD was 3.14 (1.26-7.84) in Southern Africans, 6.35 (2.53-15.96) in West Africans, and 5.26 (1.91-14.43) in Caribbeans. Higher CD4 cell count and suppressed HIV replication were associated with reduced risk of ESKD. The risk of ESKD varied among HIV-positive people of African heritage, with the highest rates observed in those of West African descent.
Highlights
A large number of people from different parts of sub-Saharan Africa are resident in the United Kingdom and accessing human immunodeficiency virus (HIV) care, which includes the provision of antiretroviral therapy (ART) with regular monitoring of kidney function and renal replacement therapy for those with end-stage kidney disease (ESKD), providing an opportunity within the UK health care setting to study the prevalence and incidence of Chronic kidney disease (CKD) in African populations
A large number of people from different parts of sub-Saharan Africa are resident in the United Kingdom and accessing HIV care, which includes the provision of ART with regular monitoring of kidney function and renal replacement therapy for those with ESKD, providing an opportunity within the UK health care setting to study the prevalence and incidence of CKD in African populations
After adjusting for demographic and HIV-specific parameters, we observed marked regional differences among people from sub-Saharan Africa who were resident in Britain, with prevalent CKD, incident CKD, and ESKD 2.7 to 6.4-fold more common among West Africans compared to East Africans, and intermediate rates of CKD and ESKD in Southern Africans
Summary
A large number of people from different parts of sub-Saharan Africa are resident in the United Kingdom and accessing HIV care, which includes the provision of ART with regular monitoring of kidney function and renal replacement therapy for those with ESKD, providing an opportunity within the UK health care setting to study the prevalence and incidence of CKD in African populations. In line with the distribution of APOL1 risk alleles, the rates of severe CKD would be highest among individuals from West Africa, intermediate among those from Southern Africa, and lowest among those from East Africa. We analyzed data from black Caribbean persons (who are predominantly of West African descent)
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