Point-of-care creatinine-based eGFR (StatSensor) in detecting kidney dysfunction (KD) among people living with HIV in Tanzania

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Abstract Title *

Point-of-care creatinine-based eGFR (StatSensor) in detecting kidney dysfunction (KD) among people living with HIV in Tanzania

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Co-author 1

DANIEL MSILANGA pascodanny07@gmail.com Muhimbili University of Health and Allied Sciences Internal Medicine Dar es Salaam Tanzania *

Co-author 2

ANTHONY MUIRU Anthony.Muiru@ucsf.edu UCSF MEDICINE SAN FRANCISCO United States -

Co-author 3

JACQUELINE SHOO shoojacqueline@gmail.com MUHIMBILI NATIONAL HOSPITAL INTERNAL MEDICINE DAR ES SALAAM Tanzania -

Co-author 4

JONATHAN MNGUMI jonawilly01@gmail.com MUHIMBILI NATIONAL HOSPITAL INTERNAL MEDICINE DAR ES SALAAM Tanzania -

Co-author 5

EMMANUEL BALANDYA ebalandya@yahoo.com MUHIMBILI UNIVERSITY OF HEALTH AND ALLIED SCIENCES INTERNAL MEDICINE DAR ES SALAAM Tanzania -

Co-author 6

RAJENDRA BHIMMA BHIMMA@ukzn.ac.za University of KwaZulu-Natal NEPHROLOGY DURBUN South Africa -

Co-author 7

KATHLEEN LIU kathleen.liu@ucsf.edu UCSF MEDICINE SAN FRANCISCO United States -

Co-author 8

Co-author 9

Co-author 10

Co-author 11

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Introduction

In Tanzania, among people living with HIV initiating antiretroviral therapy (ART), only a third receive the recommended kidney function assessment using serum creatinine testing. Among those tested, approximately 10% have moderate to severe kidney disease, with an incidence of 110 cases per 1,000 person-years. Despite this substantial burden, routine screening remains limited due to inadequate laboratory infrastructure, this common challenges across sub-Saharan Africa. This study evaluated the diagnostic performance of the StatSensor® Creatinine POC test in detecting KD among PLHIV attending the HIV clinic in Tanzania.

Methods

Serum creatinine was measured in parallel using POC StatSensor® and the Jaffé method, which served as a reference standard for KD. Agreement between the two methods was assessed using Bland-Altman analysis. The diagnostic accuracy of the StatSensor® in diagnosing KD (defined as estimated glomerular filtration rate (eGFR) <60mls/min) was determined using sensitivity, specificity, and predictive values.

Results

The study included 358 patients with a median age of 48 years (IQR: 39–54), and the prevalence of KD was 15.6%. The StatSensor® demonstrated high diagnostic accuracy (94.4%) with strong agreement (Kappa = 0.805, p < 0.001) compared to the Jaffé method, showing a sensitivity of 92.9% and specificity of 94.7%. The Bland-Altman analysis showed a positive bias of 4.36 with wide limits of agreement between StatSensor® eGFR and the Jaffé method. (Table 1 and Figure 1)

Conclusion

Conclusion: StatSensor® demonstrated strong agreement with the Jaffé method, making it a reliable tool for screening kidney disease in HIV clinics within resource-limited settings.

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