Prevalence and predictors of chronic kidney disease in newly diagnosed human immunodeficiency virus patients in Owerri, Nigeria

Anyabolu, Ernest Ndukaife; Chukwuonye, Innocent Ijezie; Arodiwe, Ejikeme; Ijoma, CK; Ulasi, Ifeoma

doi:10.4103/0971-4065.156115

Cited by 20 publications

(26 citation statements)

References 24 publications

(40 reference statements)

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“…However, the study did not assess CD4 different levels, differing from this study. Renal diseases are common in HIV infection and tend to increase with HIV disease progression, influenced by different levels of immunosuppression [15,26]. However, this study has demonstrated variable association between proteinuric renal damage and different levels of immunosuppression.…”

Section: Discussionmentioning

confidence: 54%

“…Clear instructions were given to all the subjects on how to collect 24 h urine sample. For each participant, day-time blood samples and spot urine samples were collected at the end of the 24 h urine sample collection [8,[14][15][16].…”

Section: Methodsmentioning

confidence: 99%

“…Creatinine was determined by modified Jeff's method and protein by photometric method. Creatinine clearance (ClCr) was determined [8,[14][15][16].…”

Section: Methodsmentioning

confidence: 99%

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Variable Influencing Parameters of Different Levels of Immunosuppression in HAART-naive HIV Subjects in Nigeria

Anyabolu¹

2017

Clin Microbiol

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Background and Objectives: Varying degrees of immunosuppression may be observed in human immunodeficiency virus (HIV) infected subjects. This study sought to evaluate the factors which might influence different levels of immunosuppression in this group of subjects. Methodology: Immunosuppression, defined as CD4<500 cells/ml, was evaluated in treatment-naïve HIV subjects. Body mass index (BMI), 24 h urine creatinine (24HUCr), 24 h urine protein (24HUP), creatinine clearance (ClCr), hemoglobin (Hb) and CD4 cells count were determined and the data compared among the subjects who have different levels of immunosuppression, defined here as mild for CD4 350-499 cells/ml, moderate for CD4 200-349 cells/ml and severe for CD4<200 cells/ml. Results: CD4 cells count 200-349/ml was prevalent in 31.3%, CD4 350-499/ml in 25.4% and CD4 ≥ 500 cells/ml in 122(31.0%) of the HIV subjects. Immunosuppression was significantly associated with BMI (df=9, p=0.008), 24HUCr (df=6, p=0.019) and anemia (df=9, p<0.001). None of these three variables, in addition to 24HUP, was a predictor of moderate immunosuppression (CD4 cells count 200-349/ml). However, BMI, ClCr, 24HUP and Hb were predictors of mild immunosuppression (CD4 350-499 cells/ml) (p=0.006, p=0.008, p=0.026 and p=0.003 respectively). Conclusion: Variable levels of immunosuppression were prevalent in this study. Anemia, abnormal weight and renal damage were common but variable in subjects who have different levels of immunosuppression in the early stage of HIV infection.

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Section: Discussionmentioning

confidence: 54%

Section: Methodsmentioning

confidence: 99%

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Variable Influencing Parameters of Different Levels of Immunosuppression in HAART-naive HIV Subjects in Nigeria

Anyabolu¹

2017

Clin Microbiol

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“…Apart from Msango's work in Tanzania, which had a prevalence of 63.7% [9] higher than ours, all similar work in Africa had found prevalence equal to or lowers than our result. Ekat in Brazzaville [5], Anyabolu in Nigeria [10] found a prevalence of 42% and 22.5% respectively. The difference in methodology is the main explanation for this great variability of prevalence in these different works.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors of Renal Failure in HIV Patients at Initiation of ARV Treatment: Retrospective Study of 3118 Patients Followed in Infectious Diseases Department at Lom&#233; University Hospital

Amekoudi¹,

Sabi²,

Dolaama³

et al. 2019

OJNeph

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HIV infection is a major cause of chronic kidney disease, associated with high morbidity and mortality in sub-Saharan Africa. The objective of this study is to assess the prevalence and risk factors of renal disease at initiation of antiretroviral therapy. This was a descriptive and analytical retrospective study carried out in the infectious and tropical diseases department at Sylvanus Olympio University Hospital. The data have been extracted from the ESOPE software. Kidney disease was defined by a GFR, estimated by MDRD (Modification of Diet in Renal Disease) formula, less than 60 ml/min/1.73 m 2. Risk factors associated with kidney disease were assessed using univariate and multivariate analysis. There were 3118 HIV-infected patients included in our study. The median estimated filtration rate was 94.7 ml/min/1.73 m 2 : 2.9% had an eGFR < 15 ml/min/1.73 m 2. 1303 had kidney disease (41.8%). Most patients (30.8%) were in the WHO clinical stage 1. The median CD4 count was 165/µL [IQR = 72-274/µL]; the median hemoglobin level was 10.4 g/dL [IQR = 8.8-11.9 g/dL]; all patients had thrombocytopenia less than 100.000/mm 3 ; 8.5% had leukocytosis greater than 10.000/mm 3. Most of patients had HIV1. In the multivariate analysis, age greater than 40 years (p < 0.0001), and female gender and hyperleukocytosis greater than 10,000/mm 3 were significantly associated with renal disease. The prevention of kidney disease must go through the identification of its risk factors in the target populations.

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“…However, multi-linear regression analysis showed SUCr was not a predictor of proteinuria. SUCr is known to vary over 24 hours of the days and may not indicate quantitatively the presence of renal damage [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

A look at risk factors of proteinuria in subjects without impaired renal filtration function in a general population in Owerri, Nigeria

Anyabolu¹,

Chukwuonye²,

Anyabolu³

et al. 2016

Pan Afr Med J

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IntroductionProteinuria is a common marker of kidney damage. This study aimed at determining predictors of proteinuria in subjects without impaired renal filtration function in Owerri, Nigeria.MethodsThis was a cross-sectional study involving 136 subjects, consecutively drawn from Federal Medical Centre (FMC), Owerri, Nigeria. Relevant investigations were performed, including 24-hour urine protein (24HUP). Correlation and multivariate linear regression analysis were used to determine the association and strength of variables to predict proteinuria. Proteinuria was defined as 24HUP ≥0.300g and impaired renal filtration function as creatinine clearance (ClCr) <90mls/min. P<0.05 was taken as statistically significant.ResultsMean age of subjects was 38.58 ±11.79 years. Female/male ratio was 3:1. High 24-hour urine volume (24HUV) (p<0.001), high spot urine protein/creatinine ratio (SUPCR) (p<0.001), high 24-hour urine protein/creatinine ratio (24HUPCR) (p<0.001), high 24-hour urine protein/osmolality ratio (24HUPOR) (p<0.001), low 24-hour urine creatinine/osmolality ratio (24HUCOR) (p<0.001), and low spot urine protein/osmolality ratio (SUPOR) (p<0.001), predicted proteinuria in this study.ConclusionThe risk factors of proteinuria in subjects without impaired renal filtration function in Owerri, Nigeria, included 24HUV, SUPCR, 24HUPCR, 24HUPOR, 24HUCOR and SUPOR. Further research should explore the relationship between urine creatinine and urine osmolality, and how this relationship may affect progression of kidney damage, with or without impaired renal filtration function.

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Prevalence and predictors of chronic kidney disease in newly diagnosed human immunodeficiency virus patients in Owerri, Nigeria

Cited by 20 publications

References 24 publications

Variable Influencing Parameters of Different Levels of Immunosuppression in HAART-naive HIV Subjects in Nigeria

Variable Influencing Parameters of Different Levels of Immunosuppression in HAART-naive HIV Subjects in Nigeria

Risk Factors of Renal Failure in HIV Patients at Initiation of ARV Treatment: Retrospective Study of 3118 Patients Followed in Infectious Diseases Department at Lom&#233; University Hospital

A look at risk factors of proteinuria in subjects without impaired renal filtration function in a general population in Owerri, Nigeria

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Prevalence and predictors of chronic kidney disease in newly diagnosed human immunodeficiency virus patients in Owerri, Nigeria

Cited by 20 publications

References 24 publications

Variable Influencing Parameters of Different Levels of Immunosuppression in HAART-naive HIV Subjects in Nigeria

Variable Influencing Parameters of Different Levels of Immunosuppression in HAART-naive HIV Subjects in Nigeria

Risk Factors of Renal Failure in HIV Patients at Initiation of ARV Treatment: Retrospective Study of 3118 Patients Followed in Infectious Diseases Department at Lom&amp;#233; University Hospital

A look at risk factors of proteinuria in subjects without impaired renal filtration function in a general population in Owerri, Nigeria

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Risk Factors of Renal Failure in HIV Patients at Initiation of ARV Treatment: Retrospective Study of 3118 Patients Followed in Infectious Diseases Department at Lomé University Hospital