Prevalence and factors associated with impaired renal function among Chronic Hepatitis B infected patients attending Hepatitis B Clinic at Mulago Hospital
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Background: Uganda has a high prevalence of hepatitis B virus (HBV) infection, with more than 3.5 million Ugandans living with chronic hepatitis B (CHB) virus infection. CHB virus infection has been linked to renal disease but little is known about its prevalence in Uganda. Study Objective: To determine the prevalence and factors associated with impaired renal function among CHB virus infected patients attending hepatitis B clinic at MNRH outpatient department. Methods: We conducted a cross-sectional study among 190 consecutively selected CHB virus infected adults attending the HBV clinic at MH. Data was collected using interviewer-administered questionnaires on patient’s medical history and physical examination (Blood pressure, weight, height and presence of tattoos). Urine samples were collected and analyzed for protein, red blood cells and myoglobin. Blood samples were also analyzed for renal and liver function tests, and random blood sugar. Results: Fifty eight percent of the study participants were male (111/190), median age was29(IQR: 25-33). The prevalence of impaired renal function (eGFR˂90mL/min/1.73m2CKD- Epi formula) among CHB virus infected patients was 22.1% (95% CI: 16.72-28.62). Factors which were strongly associated with impaired renal functions were female sex (aOR: 2.904, 95%CI1.39-6.08, p<0.005) and abnormal alanine phosphatase (ALP) (aOR: 3.027, 95% CI 1.42-6.44, p˂0.004). Conclusion: This study demonstrated a high prevalence of impaired renal function among the patients with CHB virus infection. Most patients were asymptomatic indicating undiagnosed renal dysfunction in patients with CHB virus infection. Recommendations: Regular routine screening for impaired renal function is highly recommended for patients with CHB virus infection.