Renal abnormalities among HIV infected children at Muhimbili National Hospital (MNH)—Dar es Salaam, Tanzania

Fredrick, Francis; Francis, Joel Msafiri; Ruggajo, Paschal; Maro, E E

doi:10.1186/s12882-016-0242-6

Cited by 30 publications

(47 citation statements)

References 26 publications

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“…The most recent and similar study done in Tanzania [14] found prevalence at 20.4% which is close to that demonstrated by our study (18.9%) though it assessed HIV − infected children. However, a study from South Africa [8] found the prevalence of microalbuminuria at 24.0%.…”

Section: Discussionsupporting

confidence: 91%

“…This study looked at HIV − infected ART naïve patients attending the Mulago ISS clinic and the prevalence of microalbuminuria reported was different from most of the studies conducted in recent times [5,6,[8][9][10][11][12][13][14]. It was challenging to compare this study with those conducted earlier due to several factors which include differing study participants and sample sizes, in addition to varying assay techniques and methodologies.…”

Section: Discussionmentioning

confidence: 88%

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Prevalence of microalbuminuria and associated factors among HIV − infected ART naïve patients at Mulago hospital: a cross-sectional study in Uganda

et al. 2020

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Background HIV infection affects multiple organs and the kidney is a common target making renal disease, one of the recognized complications. Microalbuminuria represents an early, important marker of kidney damage in several populations including HIV-infected antiretroviral therapy (ART) naïve patients. Early detection of microalbuminuria is critical to slowing down progression to chronic kidney disease (CKD) in HIV-infected patients, however, the burden of microalbuminuria in HIV-infected antiretroviral therapy (ART) naïve patients in Uganda is unclear. Methods A cross-sectional study was conducted in the Mulago Immune suppression syndrome (ISS) clinic among adult HIV − infected ART naïve outpatients. Data on patient demographics, medical history was collected. Physical examination was performed to assess body mass index (BMI) and hypertension. A single spot morning urine sample from each participant was analysed for microalbuminuria using spectrophotometry and colorimetry. Microalbuminuria was defined by a urine albumin creatinine ratio (UACR) 30-299 mg/g and macroalbuminuria by a UACR > 300 mg/g. To assess the factors associated with microalbuminuria, chi-square, Fisher’s exact test, quantile regression and logistic regression were used. Results A total of 185 adult participants were consecutively enrolled with median age and CD4+ counts of 33(IQR = 28–40) years and 428 (IQR = 145–689) cells/μL respectively. The prevalence of microalbuminuria was 18.9% (95% CI, 14–25%). None of the participants had macroalbuminuria. CD4+ count <350cells/μL was associated with increased risk of microalbuminuria (OR: 0.27, 95% CI: 0.12–0.59), P value = 0.001). Diabetes mellitus, hypertension, smoking, alcohol intake were not found to be significantly associated with microalbuminuria. Conclusion Microalbuminuria was highly prevalent in adult HIV − infected ART naive patients especially those with low CD4+ count. There is need to study the effect of ART on microalbuminuria in adult HIV − infected patients.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 88%

Prevalence of microalbuminuria and associated factors among HIV − infected ART naïve patients at Mulago hospital: a cross-sectional study in Uganda

et al. 2020

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“…The occurrence of microalbuminuria is not related to age. This result is similar to the results reported by Fredrick [16], who observed that microalbuminuria was equally distributed across all age groups, suggesting that, regardless age, there is a continuum of renal features from the microalbuminuria which progresses towards proteinuria. On the other hand, Eke et al [14] showed that microalbuminuria is more likely to occur in older children.…”

Section: Discussionsupporting

confidence: 91%

“…and 28.8% in works by Fredick [16] and Mosten [17], both from Tanzania. Dimock [18] from Bethesda in US reported a prevalence of 15%.…”

Section: Discussionmentioning

confidence: 95%

Prevalence and Risk Factors for Albuminuria among HIV Ivorian Children, Using the Dipstick Method

Melanie¹,

Eugene²,

Amelie³

et al. 2018

OJNeph

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Context: Human immunodeficiency virus (HIV) infected children are at risk of developing chronic kidney disease defined by decreased glomerular filtration rate and or proteinuria. Studies on the prevalence of and risk factors for proteinuria among HIV-infected children in sub-Saharan Africa are scarce and in Cote d'Ivoire, there is paucity of reported data. We determined the prevalence of and the risk factors for proteinuria among HIV-infected Ivorian children in both ART (antiretroviral therapy)-naïve and ART-exposed children. Method: It was a cross-sectional bi-centric study, conducted from July 2013 to April 2014. Each child's urine was tested for proteinuria and microalbuminuria using multi test strips and mitral test, respectively. Proteinuria was defined as of significant of 1+ and above on the dipstick or the presence of microalbuminuria ≥ 20 mg/l. Results: Of the 155 HIV-infected children enrolled, there were 78 boys.Sixty seven point seven percent were treated with antiretroviral and 74.1% had treatment duration of less than 5 years. In the first dipstick test, the prevalence of proteinuria was 29% which persisted in 9.7% after 24 hour urinary protein examination. It was significantly different between the 2 groups treated and naïve (2.8% versus 24%). The advanced CDC clinical stage emerged as the main independent determinant of proteinuria. Conclusion: Proteinuria is common in HIV-infected Ivorian children. Screening for proteinuria in HIV-infected children will help in early and treatment, and thus prevention and progression to chronic kidney disease to end-stage kidney disease.

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“…This high prevalence of microalbuminuria highlights the magnitude of early renal dysfunction in HIV-infected patients before ART initiation. This was different from most of the studies conducted in recent times [5][6][7][8][9][10][11][12][13].…”

Section: Discussioncontrasting

confidence: 79%

Prevalence of Microalbuminuria and associated factors among HIV−infected ART naïve patients at Mulago hospital, Kampala, Uganda.

Kiggundu¹,

Byakika-Kibwika²,

Andia-Biraro³

et al. 2020

Preprint

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Background The kidney is one of the common target organs for HIV infection. Early detection of microalbuminuria, the earliest marker of renal damage is critical to slowing down progression to end stage renal disease if appropriate intervention is made. The burden of microalbuminuria and its associated factors in HIV−infected ART naive patients has not been determined in Uganda.Methods A cross-sectional study was conducted in the Mulago Immune suppression syndrome (ISS) clinic on adult HIV−infected ART naïve outpatients. Data was collected on age, sex, level of education, marital status, religion, address, and history of alcohol intake, diabetes mellitus, hypertension, medications and smoking. Measurement of blood pressure, weight and height to determine body mass index (BMI) and investigations including complete blood count (CBC),serum urea and creatinine, Liver function tests(LFTs), CD4+ count, spot morning urine albumin and urine creatinine to determine microalbuminuria were conducted. Logistic regression was used to estimate the strength of association between variables.ResultsA total of 185 adult participants were consecutively enrolled into the study. The mean (SD) age was 34.2(±9.0) years and majority (63.8%) were female. The mean (SD) CD4+ count 466±357 cells/µL, and BMI 23.1 (±4.9) kg/m 2 . The prevalence of microalbuminuria was 18.9%. None of the participants had albuminuria. CD4+ count <350cells/µL and BM1<18.5kg/m 2 were associated increased risk of microalbuminuria OR 3.8 (95%CI 1.7-8.3) (p value=0.01) and OR 4.7 (95%CI 1.82-12.4) (p value=0.03) respectively. Diabetes mellitus, hypertension, smoking, alcohol intake were not found to be significantly associated with microalbuminuria.Conclusion Microalbuminuria was highly prevalent in adult HIV−infected ART patients especially those with low CD4+ count and low BMI. There is need to study the effect of ART on microalbuminuria in adult HIV−infected patients. Key words: HIV, microalbuminuria, Uganda, ART naïve

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Renal abnormalities among HIV infected children at Muhimbili National Hospital (MNH)—Dar es Salaam, Tanzania

Cited by 30 publications

References 26 publications

Prevalence of microalbuminuria and associated factors among HIV − infected ART naïve patients at Mulago hospital: a cross-sectional study in Uganda

Prevalence of microalbuminuria and associated factors among HIV − infected ART naïve patients at Mulago hospital: a cross-sectional study in Uganda

Prevalence and Risk Factors for Albuminuria among HIV Ivorian Children, Using the Dipstick Method

Prevalence of Microalbuminuria and associated factors among HIV−infected ART naïve patients at Mulago hospital, Kampala, Uganda.

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