Prevalence and Pattern of Chronic Kidney Disease in Antiretroviral-Naïve Patients with HIV/AIDS

J Int Assoc Provid AIDS Care. 2015 Sep-Oct;14(5):434-40. doi: 10.1177/2325957415587570. Epub 2015 May 26.

Abstract

Background: Chronic renal failure and HIV/AIDS are both prevalent in Nigeria. We performed a cross-sectional analysis of renal function in newly diagnosed, treatment-naive HIV-infected patients before initiating highly active antiretroviral therapy.

Methods: Treatment-inexperienced individuals were recruited. Patients with diabetes mellitus and hypertension were excluded. Plasma creatinine level was used to measure the estimated glomerular filtration rate ([eGFR] by Modification of Diet in Renal Disease equation). Predictors of creatinine and eGFR were determined by univariate and multivariate analyses.

Results: We evaluated 183 patients. In all, 44 (24%) patients had a GFR <60 mL/min/1.73 m(2), implying moderate chronic kidney disease (CKD). Considering the eGFR, 22 (12%) patients had stage 1, 117 (63.9%) stage 2, 13 (7.1%) stage 3, 27 (14.8%) stage 4, and 4 (2.2%) stage 5 CKD. Creatinine inversely correlated with CD4 (r = -.228, P = .025). CD4 predicts creatinine (odds ratio 1.6, 95% confidence interval 1.0-1.8, P = .003).

Conclusion: In ART-naive patients, CKD is common, and low eGFR was associated with lower CD4 counts.

Keywords: HIV/AIDS; Modification of Diet in Renal Disease (MDRD); antiretroviral naive; chronic kidney disease; estimated glomerular filtration rate (eGFR).

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active
  • Cross-Sectional Studies
  • Female
  • Glomerular Filtration Rate
  • HIV Infections / complications*
  • HIV Infections / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Nigeria / epidemiology
  • Prevalence
  • Renal Insufficiency, Chronic / epidemiology
  • Renal Insufficiency, Chronic / physiopathology
  • Renal Insufficiency, Chronic / virology*
  • Young Adult