Prevalence of persistent proteinuria in stable HIV/AIDS patients and its association with HIV nephropathy

Cavalcante, Maria Alina Gomes de Mattos; Coelho, Sandra N.; Lacerda, Heloísa Ramos

doi:10.1590/s1413-86702007000500003

Cited by 15 publications

(11 citation statements)

References 28 publications

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“…[13] Moreover, lower number of patients in our study were on cART (65.9%), compared to studies from the United States (77%) and Brazil (92%). [1920] We have also reported a comparatively higher prevalence of dipstick proteinuria in this study (29%). This is comparable to two large studies from the United States reporting proteinuria of 29.8% and 32%.…”

Section: Discussionsupporting

confidence: 71%

Clinical spectrum of renal disease in hospitalized HIV/AIDS patients: A teaching hospital experience

Verma¹,

Singh²

2019

J Family Med Prim Care

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Background: Renal involvement in HIV patients is relatively common and quite broad. However, despite an increasingly large number of HIV patients in Asia, systematic studies of renal involvement are lacking. Objectives: The study was carried out to delineate the clinical spectrum of renal disease in HIV/AIDS patients hospitalised in a tertiary care centre. Patients and Methods: A total of 510 consecutive hospitalised HIV/AIDS with age >18years were included in the study. Detailed demographic, clinical and laboratory data including urinalysis was obtained from all participants. Results: Electrolyte disorders were seen in 71% of patients, with the most frequent being hyponatremia (61%). Acute renal failure was seen in 15.8% and CKD was found in 13% of HIV patients. Dipstick proteinuria of grade ≥1+ was seen in 147 patients (29% of total). CD4 count had a significant positive correlation with creatinine clearance, hyponatremia and total leukocyte count, and significant negative correlation with duration of disease and proteinuria. Conclusion: Electrolyte disorders and renal involvement are quite common in HIV/AIDS patients from India. Prompt diagnosis and management is required as their presence carry higher morbidity and mortality.

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Section: Discussionsupporting

confidence: 71%

Clinical spectrum of renal disease in hospitalized HIV/AIDS patients: A teaching hospital experience

Verma¹,

Singh²

2019

J Family Med Prim Care

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“…Furthermore, the recent Kidney Disease Initiative and Global Outcome (KDIGO) CKD Guidelines recommend, in individuals with proteinuria by dipstick, to perform confirmatory protein quantification within 3 months [24]. Defining proteinuria as a positive urine dipstick test on two occasions [25] could have reduced the false positive rate in our study, but probably at the expense of an even higher false negative rate.…”

Section: Discussionmentioning

confidence: 90%

Prevalence of microalbuminuria and diagnostic value of dipstick proteinuria in outpatients from HIV clinics in Bukavu, the Democratic Republic of Congo

et al. 2014

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BackgroundMicroalbuminuria is a marker of early kidney disease and high cardiovascular risk in various populations, including HIV positive patients. However, the diagnostic value of qualitative (dipstick) proteinuria and the burden of microalbuminuria in HIV positive patients living in sub-Saharan Africa are relatively unclear.MethodsIn a cross-sectional study, 235 HIV- positive outpatients were screened for proteinuria in 3 HIV-clinics in Bukavu. A spot urine sample from each subject was tested both by a dipstick and albumin-creatinine-ratio (ACR) assay. The performance of dipstick proteinuria exceeding 1+ was compared with that of microalbuminuria (≥30 mg/g creatinine).ResultsThe prevalence of microalbuminuria and dipstick proteinuria ≥ (1+), ≥ (2+) and ≥ (3+) was 11%, 41%, 3.5% and 0.7%, respectively.Compared to microalbuminuria, the dipstick (proteinuria of 1+ or greater) had an overall sensitivity of 60% and a specificity of 61%. The positive predictive value was 15.4% and the negative predictive value 92.8%.ConclusionProteinuria is highly prevalent in HIV positive patients. The limited sensitivity and specificity of the dipstick to detect significant microalbuminuria make it unattractive as a screening tool in HIV positive patients.

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“…[24] Prevalence of HIVAN in kidney biopsy series outside India have reported prevalence of HIVAN ranging from 0% to 83% [Table 2]. [7252627282930313233] HIVAN has been consistently and frequently reported in studies from North America, Western Europe and African countries. However, studies from Italy and Thailand have shown complete absence of this entity.…”

Section: Discussionmentioning

confidence: 99%

Histological spectrum of renal disease in HIV/AIDS patients with significant proteinuria: An Indian perspective

Verma¹,

Singh²

2019

J Family Med Prim Care

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Background: Chronic kidney disease (CKD) has become epidemic in HIV/AIDS patients across Western and Eastern countries. HIV-associated nephropathy (HIVAN) has been consistently reported in studies from North America, Europe and African countries. However, studies from Asian countries are very sparse and differ strikingly in histological spectrum of renal disease, particularly in presence of HIVAN. Objectives: The study was carried out to in a teaching hospital from India to delineate the histological spectrum of renal disease and detect presence HIVAN in those with significant proteinuria (≥1gm/day). Patients and Methods: Urine analysis was done in 510 consecutive hospitalised HIV/AIDS patients after screening 640 such patients with age >18years. Patients with dipstick proteinuria ≥1+ were subjected to 24-hour urinary protein estimation. Renal biopsy was done in 10 patients with proteinuria ≥1gm/day. Results: Dipstick proteinuria ≥1+ was present in 29% patients. In patients undergoing kidney biopsy, the most frequent glomerular lesion was mesangial proliferative glomerulonephritis (30%) followed by HIVAN (20%). Tubulo-interstitial lesions were seen in 60% of biopsies. Pooled analysis of all the available kidney biopsy series from India revealed prevalence of HIVAN to be 16.5%. Conclusion: Contrary to the popular belief, HIVAN appears to be a common entity in this part of world too. High degree of clinical suspicion is required as diagnosis of HIVAN caries higher morbidity and mortality. Moreover, an early diagnosis and timely management can improve prognosis in such patients.

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Prevalence of persistent proteinuria in stable HIV/AIDS patients and its association with HIV nephropathy

Cited by 15 publications

References 28 publications

Clinical spectrum of renal disease in hospitalized HIV/AIDS patients: A teaching hospital experience

Clinical spectrum of renal disease in hospitalized HIV/AIDS patients: A teaching hospital experience

Prevalence of microalbuminuria and diagnostic value of dipstick proteinuria in outpatients from HIV clinics in Bukavu, the Democratic Republic of Congo

Histological spectrum of renal disease in HIV/AIDS patients with significant proteinuria: An Indian perspective

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