The role of albuminuria in the follow-up of HIV-infected pediatric patients

Abstract

Mild proteinuria affected approximately one fifth of patients in our cohort. The determination of albuminuria allowed the differentiation between glomerular and tubular proteinuria, although no relationship with metabolic comorbidities was observed.

Prevalence of risk factors for chronic kidney disease in South African youth with perinatally acquired HIV

“…GFR was also normal with no difference between those with or without HIV. Other cohorts have reported similar findings [13,14,26].…”

“…Other studies have reported a prevalence of microalbuminuria between 10 and 30% in African HIV+ children [12,13,17]. The lower prevalence found in this cohort could be due to children starting ART relatively earlier than in other African cohorts, or fewer children receiving a TDF-based regimen.…”

“…Previous studies in HIV+ adults have shown that decreased CD4 counts, higher HIV-RNA levels and non-nucleoside reverse transcriptase inhibitors are associated with increased prevalence of microalbuminuria [10]. Studies have reported that microalbuminuria is present in 11-15% of HIV-infected children on ART in the USA, Spain and Brazil [12][13][14]. However, an Indian study reported that in a cohort of HIV+ children on ART with a mean age of 11.5 years, 20% had microalbuminuria [15].…”

Cystatin C

“…5,6 However, persistent renal function abnormalities occur in one fifth of HIV-infected children and are associated with improved survival, black race and Hispanic ethnicity and exposure to nephrotoxic drugs. 7,8 Current recommendations in children and adolescents with HIV and no previous evidence of kidney disease suggest screening for renal dysfunction with estimated glomerular filtration rate (GFR) at HAART initiation or change and at least twice yearly, and for kidney damage (urinalysis or quantitative proteinuria) at HAART initiation or change and at least yearly 5,9 or, if the patient is receiving tenofovir, at shorter intervals (3-6 months). 6 The best method for estimating GFR in children remains uncertain.…”