News / National
Lifeline for Zimbabweans living with HIV, kidney disease
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People living with HIV in Zimbabwe are increasingly facing a deadly paradox. Antiretroviral therapy (ART), which has been instrumental in extending lives and suppressing HIV, is also contributing to a rising tide of kidney damage among long-term recipients. The situation presents a dire Catch-22: stopping ART is not an option due to the risk of uncontrolled HIV replication, yet continuing treatment can worsen kidney health and lead to chronic kidney disease (CKD) or even end-stage renal failure.
With limited access to renal services in Zimbabwe's public health sector, many people living with HIV (PLHIV) view kidney failure as an inevitable death sentence. Nationwide, only around 700 renal patients can access life-saving dialysis monthly - far fewer than the more than 1,000 in desperate need of the therapy.
In a long-overdue move, the National AIDS Council (NAC) has partnered with Parirenyatwa Group of Hospitals to provide vital dialysis services to PLHIV through the hospital's renal unit. The initiative is also open to other patients with kidney disease and includes funding for dialysis reagents and consumables.
Speaking after the launch of the partnership, NAC CEO Dr Bernard Madzima described the intervention as a critical step in protecting the lives of ART recipients. "This isn't just about machines and reagents; it's about dignity, about quality of life, and ensuring that the people we have fought so hard to keep alive through ART don't die from something we can treat," said Dr Madzima.
Certain ART drugs, such as Tenofovir disoproxil fumarate (TDF), have been directly linked to kidney toxicity. Long-term use of these medications can damage kidney cells, leading to HIV-associated nephropathy (HIVAN). This risk is compounded by comorbidities like hypertension, diabetes, and cardiovascular disease, which are more common in PLHIV and further increase the chances of renal failure.
According to Dr Nicholas Mpinga, a nephrologist based in Harare, kidney disease in HIV-positive patients stems from a complex mix of factors. "HIVAN, ART toxicity, pre-existing health conditions, and even genetic predispositions contribute to CKD," he said. "We need a comprehensive care model that includes early detection, tailored ART regimens, and access to kidney replacement therapies such as dialysis."
Dr Mpinga called for multidisciplinary teams involving nephrologists, HIV specialists, and other medical professionals, and emphasised the importance of patient education. "Integrated care not only improves diagnosis and treatment but also empowers patients to understand their condition and participate in decisions about their health."
Zimbabwe's new programme marks a significant policy shift, recognising that HIV care must be integrated with chronic disease management. Dr Madzima noted that the dialysis services at Parirenyatwa require about US$700,000 annually, and that with additional donor support, the model could be expanded to other provincial hospitals. "As NAC, we felt the need to step in and assist after Parirenyatwa Hospital reached out to us asking for assistance. It's a timely intervention that improves the quality of life for those in need," he said.
The initiative has drawn praise from health advocates, including the Zimbabwe Non-Communicable Diseases (NCD) Champions Network led by Advocate Jacob Ngwenya. "We need a full continuum of care for renal disease, from prevention to palliative care," said Ngwenya. He urged the government to decentralise the model and ensure all provinces have equitable access to renal health services. "By working together, Zimbabwe can create a healthcare system that is equitable, accessible, and responsive to the needs of all citizens."
The burden of renal disease in Zimbabwe continues to grow silently, particularly among PLHIV on lifelong ART. Research shows they are up to four times more likely to develop CKD than the general population, often without early symptoms. Left unchecked, the condition progresses to end-stage renal disease (ESRD), requiring dialysis or transplantation to sustain life.
Side effects from ART can include more than just kidney damage. Patients may experience bone density loss, liver toxicity, lipodystrophy, gastrointestinal problems, and metabolic disturbances - all of which require specialised management. While ART remains essential for viral suppression, the growing complexity of side effects demands a shift toward integrated, patient-centred care.
Zimbabwe's new initiative aligns the country with global best practices by embracing integrated care models for chronic disease management. Experts say this shift is crucial not only for improving outcomes in HIV care but also for strengthening the overall healthcare system.
As Zimbabwe faces the dual challenge of HIV and chronic kidney disease, the NAC's kidney care programme offers a beacon of hope. It shows that with political will, partnership, and community support, even the most complex health challenges can be met with compassion, innovation, and resilience.
With limited access to renal services in Zimbabwe's public health sector, many people living with HIV (PLHIV) view kidney failure as an inevitable death sentence. Nationwide, only around 700 renal patients can access life-saving dialysis monthly - far fewer than the more than 1,000 in desperate need of the therapy.
In a long-overdue move, the National AIDS Council (NAC) has partnered with Parirenyatwa Group of Hospitals to provide vital dialysis services to PLHIV through the hospital's renal unit. The initiative is also open to other patients with kidney disease and includes funding for dialysis reagents and consumables.
Speaking after the launch of the partnership, NAC CEO Dr Bernard Madzima described the intervention as a critical step in protecting the lives of ART recipients. "This isn't just about machines and reagents; it's about dignity, about quality of life, and ensuring that the people we have fought so hard to keep alive through ART don't die from something we can treat," said Dr Madzima.
Certain ART drugs, such as Tenofovir disoproxil fumarate (TDF), have been directly linked to kidney toxicity. Long-term use of these medications can damage kidney cells, leading to HIV-associated nephropathy (HIVAN). This risk is compounded by comorbidities like hypertension, diabetes, and cardiovascular disease, which are more common in PLHIV and further increase the chances of renal failure.
According to Dr Nicholas Mpinga, a nephrologist based in Harare, kidney disease in HIV-positive patients stems from a complex mix of factors. "HIVAN, ART toxicity, pre-existing health conditions, and even genetic predispositions contribute to CKD," he said. "We need a comprehensive care model that includes early detection, tailored ART regimens, and access to kidney replacement therapies such as dialysis."
Dr Mpinga called for multidisciplinary teams involving nephrologists, HIV specialists, and other medical professionals, and emphasised the importance of patient education. "Integrated care not only improves diagnosis and treatment but also empowers patients to understand their condition and participate in decisions about their health."
Zimbabwe's new programme marks a significant policy shift, recognising that HIV care must be integrated with chronic disease management. Dr Madzima noted that the dialysis services at Parirenyatwa require about US$700,000 annually, and that with additional donor support, the model could be expanded to other provincial hospitals. "As NAC, we felt the need to step in and assist after Parirenyatwa Hospital reached out to us asking for assistance. It's a timely intervention that improves the quality of life for those in need," he said.
The initiative has drawn praise from health advocates, including the Zimbabwe Non-Communicable Diseases (NCD) Champions Network led by Advocate Jacob Ngwenya. "We need a full continuum of care for renal disease, from prevention to palliative care," said Ngwenya. He urged the government to decentralise the model and ensure all provinces have equitable access to renal health services. "By working together, Zimbabwe can create a healthcare system that is equitable, accessible, and responsive to the needs of all citizens."
The burden of renal disease in Zimbabwe continues to grow silently, particularly among PLHIV on lifelong ART. Research shows they are up to four times more likely to develop CKD than the general population, often without early symptoms. Left unchecked, the condition progresses to end-stage renal disease (ESRD), requiring dialysis or transplantation to sustain life.
Side effects from ART can include more than just kidney damage. Patients may experience bone density loss, liver toxicity, lipodystrophy, gastrointestinal problems, and metabolic disturbances - all of which require specialised management. While ART remains essential for viral suppression, the growing complexity of side effects demands a shift toward integrated, patient-centred care.
Zimbabwe's new initiative aligns the country with global best practices by embracing integrated care models for chronic disease management. Experts say this shift is crucial not only for improving outcomes in HIV care but also for strengthening the overall healthcare system.
As Zimbabwe faces the dual challenge of HIV and chronic kidney disease, the NAC's kidney care programme offers a beacon of hope. It shows that with political will, partnership, and community support, even the most complex health challenges can be met with compassion, innovation, and resilience.
Source - Mirror
