Factors associated with chronic kidney disease among patients with hepatitis c infection attending Kigeme district hospital, Rwanda

Chronic hepatitis C infects an estimated 50 million people worldwide¹ and affects 4-8% of Rwandans; beyond liver injury, it can damage the kidneys via immune-complex and cryoglobulin deposition or direct viral effects. Little is known about the magnitude and factors linked to chronic kidney disease(CKD) in patients with hepatitis C virus(HCV) in Rwanda, this study aimed to find CKD prevalence and explored factors associated with CKD among hepatitis C-infected individuals under care at Kigeme District Hospital. This was a cross-sectional study of 225 hepatitis C patients attending Kigeme District Hospital, selected via systematic random sampling. Clinical and demographic data were abstracted from electronic patient files using a standardized Kobo Toolbox form, then exported to Excel for cleaning. The cleaned dataset was imported into STATA V15, where we used descriptive statistics to characterize the participants and modified passion regression to examine factors associated with CKD. Variables with p < 0.05 in bivariate analyses were entered into a multivariable modified Poisson regression model; adjusted prevalence ratios with 95% confidence intervals were reported, and statistical significance was defined as p < 0.05. Among the 225 hepatitis C seropositive patients included in the study, 27 were diagnosed with chronic kidney disease (CKD), yielding an overall CKD prevalence of 12% (95% CI: 8.05-16.9). When stratified by viremia status, CKD prevalence was higher among patients with detectable HCV RNA (18.57%; 95% CI: 10.3-29.6). In multivariable analysis, CKD was independently associated with detectable HCV RNA copies (aPR = 2.10; 95% CI: 1.05-4.18), hypertension (aPR = 2.39; 95% CI: 1.19-4.78), diabetes mellitus (aPR = 2.88; 95% CI: 1.37-6.06). Older age (aPR = 2.73; 95% CI: 1.11-6.71) was also associated with CKD, however caution should be taken due to inclusion of age in Cockcroft-Gault formula used in this study. In addition, markers of liver injury (Liver enzymes) showed associations with CKD but were interpreted cautiously due to their non-specific and binary assessment. Heart failure was not significantly associated with CKD. Chronic kidney disease is relatively common among patients with hepatitis C infection. Both viral factors, such as ongoing viral replication and liver injury, and host factors, including older age and metabolic comorbidities such as diabetes mellitus and Hypertension, play a key role in its development. Early screening and integrated management of kidney function, particularly in high-risk patients, are essential to prevent progression to advanced kidney disease.