Evidence map›Paper›PMID 41628191›Full record

ArticlePLOS global public health2026

Kidney disease screening at ART initiation among adults with HIV in Uganda: A missed priority for a high-risk population.

Grace Kansiime, Joseph Baruch Baluku, Edwin Nuwagira, Michael Kanyesigye, Paul Stephen Obwoya, Rose Muhindo, Winnie R Muyindike, Pliers Denis Tusingwire, Henry Mugerwa, Matthew Odera and 6 more

Abstract read
In one paragraph

Article in PLOS global public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Grace KansiimeDepartment of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.ORCID https://orcid.org/0000-0002-3778-7594
Joseph Baruch BalukuDepartment of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.ORCID https://orcid.org/0000-0002-5852-9674
Edwin NuwagiraDepartment of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Michael KanyesigyeGlobal Health Collaborative, Mbarara University of Science and Technology, Mbarara, Uganda.ORCID https://orcid.org/0000-0003-1936-7681
Paul Stephen ObwoyaDepartment of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Rose MuhindoDepartment of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.ORCID https://orcid.org/0000-0001-7128-4870
Winnie R MuyindikeDepartment of Medicine, Mbarara Regional Referral Hospital, Mbarara, Uganda.ORCID https://orcid.org/0000-0002-6694-2645
Pliers Denis TusingwireDepartment of Ophthalmology, Kabale University School of Medicine, Kabale, Uganda.ORCID https://orcid.org/0009-0004-3935-4612
Henry MugerwaJoint Clinical Research Centre, Kampala, Uganda.ORCID https://orcid.org/0000-0003-0575-754X
Matthew OderaJoint Clinical Research Centre, Kampala, Uganda.
Monday BusuulwaAIDS Healthcare Foundation Uganda Cares, Masaka Regional Referral Hospital, Masaka, Uganda.
Matthew SsemakaddeAIDS Healthcare Foundation Uganda Cares, Masaka Regional Referral Hospital, Masaka, Uganda.
Esther C AtukundaDepartment of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda.
Francis BajunirweDepartment of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda.ORCID https://orcid.org/0000-0002-1326-5230
Robert KalyesubulaDepartment of Physiology and Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
Mark J SiednerDepartment of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda.

Funding

Partnership for Global Health Research Training Program (Renewal)-Supplement for OBSSR, NCI, NCI-AIDS and NIDCDD43TW010543 · FIC · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Wafaie W Fawzi, DAVIDSON HOWES HAMER · 2017 to 2026
$12.1M
Integration of a patient-centered mobile health intervention (Support-Moms) into routine antenatal care to improve maternal health in UgandaR01HD111692 · NICHD · MBARARA UNIVERSITY/SCIENCE/ TECHNOLOGY · PI Esther Cathyln Atukunda · 2023 to 2026
$1.9M
Mentoring patient-oriented research to improve cardiovascular health among people with HIV in sub-Saharan AfricaK24HL166024 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI MARK J SIEDNER · 2022 to 2026
$616k
FIC NIH HHS D43 TW010543NHLBI NIH HHS K24 HL166024NICHD NIH HHS R01 HD111692
6 · The paper itself

Abstract

Kidney disease affects 850 million people worldwide, with Sub-Saharan Africa bearing a significant burden. People living with HIV (PWH) are at increased risk due to nephrotoxicity of antiretroviral therapy (ART), in part due to widespread use of tenofovir disoproxil fumarate. In response, Uganda recommends routine kidney disease screening by doing a serum creatinine test at ART initiation. However, the extent of adherence to these guidelines remains poorly understood. We extracted clinical data for adults initiating ART between 2017 and 2024 at three large-volume HIV clinics in Uganda. To determine if kidney disease screening rates had increased appropriately over time, we divided the observation period into three eras as per national guidelines: (1) Test and Treat (2017-2019), that recommended screening only PWH and diabetes or hypertension; (2) DTG rollout/COVID-19 (2020-2022); and (3) creatinine-for-all (2023-2024), recommending screening everyone initiating ART. Logistic regression models were fit to identify correlates of renal screening. Of the 17,485 participants, only 22.4% (3,909/17,485) were screened for kidney disease at ART initiation. Screening was more common at the urban site (54.2%) compared to rural sites (10.0%). At rural sites, screening declined over time and individuals were 83% less likely to be screened in the creatinine-for-all era compared to the baseline era (aOR 0.17, 95% CI: 0.13-0.22) while it increased at urban site (aOR 9.27, 95% CI: 7.37-11.66). Male sex (aOR 1.37, 95% CI: 1.20-1.57), older age (≥45 years), hypertension, and non-TDF-based ART regimens were associated with higher screening odds at rural sites. Diabetes, opportunistic infections, and TDF use were not significantly associated with screening likelihood at any site. Kidney disease screening for PWH at ART initiation remains poor in Uganda, even when using a single creatinine test, particularly in rural clinics, highlighting critical challenges in translating national guidelines into practice. Future research should focus on understanding multilevel barriers to screening and evaluating strategies to improve guideline uptake.

Identifiers

PMID41628191
PMCPMC12863478

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.