Clinical Factors Associated with Short-Term Decline in Estimated Glomerular Filtration Rate in People Living with HIV Receiving Antiretroviral Therapy: A Prospective Cohort Study.

HIV infection remains a significant public health challenge. Although antiretroviral therapy has substantially improved survival, chronic complications such as renal impairment increase morbidity and mortality, making the estimated glomerular filtration rate (eGFR) crucial for early detection. This prospective, observational, and analytical cohort study aimed to identify the clinical, sociodemographic, and laboratory factors associated with short-term eGFR decline in people living with HIV (PLWH) over a 6-month follow-up at a second-level Mexican hospital. We included 166 PLWH aged > 18 years, collecting data on serum creatinine, eGFR, viral load, and CD4+ T cell counts. Patients were stratified based on the magnitude of eGFR decline into four groups (<5, 5-9, 10-19, and ≥20 mL/min/1.73 m2). The median age was 35 years (91% male). Median eGFR was 101.81 mL/min/1.73 m2 at baseline and 100.54 mL/min/1.73 m2 at 6 months. Most patients achieved virological suppression, and only 2.4% developed chronic kidney disease. Group analysis revealed a significant association between a greater short-term eGFR decline and advanced age, unemployment, and opportunistic infections. In conclusion, short-term renal decline was primarily associated with older age and unemployment. Although chronic kidney disease incidence was low, evaluating short-term eGFR decline allowed for the identification of clinically relevant alterations, highlighting the importance of periodic renal monitoring, particularly in clinically and socially vulnerable patients.