Renal disease

Tanawattanacharoen, Somsak; Kopp, Jeffrey B.

doi:10.1017/cbo9780511544798.037

Cited by 1 publication

(6 citation statements)

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“…There is a wide clinical spectrum of renal disease in the course of HIV infection [12,13]. The mechanism of kidney involvement in HIV infection is multifactorial.…”

Section: Introductionmentioning

confidence: 99%

“…The mechanism of kidney involvement in HIV infection is multifactorial. Opportunistic infections, drugs used in the treatment of HIV and its complications or malignancies associated with advanced immunosuppression may contribute to renal disease in HIV-infected individuals [13]. Acute and chronic kidney injury have been described and the causes are similar to HIV-uninfected children [6,13].…”

Section: Introductionmentioning

confidence: 99%

“…Opportunistic infections, drugs used in the treatment of HIV and its complications or malignancies associated with advanced immunosuppression may contribute to renal disease in HIV-infected individuals [13]. Acute and chronic kidney injury have been described and the causes are similar to HIV-uninfected children [6,13]. Various electrolyte disorders particularly hyponatraemia have been documented in hospitalized HIV-infected children [13].…”

Section: Introductionmentioning

confidence: 99%

“…Acute and chronic kidney injury have been described and the causes are similar to HIV-uninfected children [6,13]. Various electrolyte disorders particularly hyponatraemia have been documented in hospitalized HIV-infected children [13]. Asharam et al in South Africa found no significant impact of HIV/AIDS on the presentation of bacterial urinary tract infection in HIV-infected children aged 0–12 years, similar to findings by O’Regan et al in Canada [14,15].…”

Section: Introductionmentioning

confidence: 99%

“…HIVAN is associated with nephrotic range proteinuria, hypoalbuminaemia and normal or low cholesterol levels [14,19-22]. Various mechanisms of glomerular injury in HIV infection have been described [5,13]. HIVAN may occur early on during the course of HIV-1 infection.…”

Section: Introductionmentioning

confidence: 99%

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Renal abnormalities among HIV-infected, antiretroviral naive children, Harare, Zimbabwe: a cross-sectional study

et al. 2013

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BackgroundData on the prevalence of renal and urine abnormalities among HIV-infected children in Sub-Saharan Africa are limited. We set out to determine the prevalence of proteinuria; low estimated glomerular filtration rate (eGFR), urinary tract infection and associated factors among HIV-infected antiretroviral therapy (ART) naive children, aged 2–12 years, attending the paediatric HIV clinic at a tertiary hospital in Harare.MethodsConsecutive ART naive children attending the clinic between June and October 2009 were recruited. Detailed medical history was obtained and a complete physical examination was performed. Children were screened for urinary tract infection and for significant persistent proteinuria. Serum creatinine was used to estimate GFR using the modified Counahan-Barratt formula. The Student’s t-test was used to analyse continuous variables and the chi-square or Fisher’s exact test was used to analyse categorical data. Logistic regression was performed to assess the relationship between study factors and urine abnormalities, persistent proteinuria and the eGFR.ResultsTwo hundred and twenty children were enrolled into the study. The median age was 90 months (Q1=65.5; Q3=116.5). The prevalence of urinary tract infection was 9.5%. Escherichia coli was the predominant organism. There was uniform resistance to cotrimoxazole. Persistent proteinuria (urine protein to creatinine ratio greater than 0.2, a week apart) was found in 5% of the children. Seventy-five children (34.6%) had mild to moderate renal impairment shown by a low eGFR (30 to <90ml/min/1.73m2). Persistent proteinuria was more likely to be found in children who were wasted, weight-for-height (WHZ) z-score <−2 (p=0.0005). Children with WHO clinical stage 4 were more likely to have a low eGFR than children with less advanced stages (OR 2.68; CI 1.24-5.80). Urine abnormalities were more likely to be observed in children with WHO clinical stages 3 and 4 (OR 2.20; CI 1.06-4.60).ConclusionThere is significant renal impairment among HIV-infected, ART naive children aged 2–12 years attending the outpatient paediatric HIV clinic at Harare Central Hospital. The abnormalities are more likely to occur in children with advanced HIV/AIDS. Screening for renal impairment and urinary tract infections in HIV-infected children before initiation of ART and regularly thereafter would be helpful in their management. Keywords: HIV, renal disease, persistent proteinuria, glomerular filtration rate, urinary tract infection

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“…There is a wide clinical spectrum of renal disease in the course of HIV infection [12,13]. The mechanism of kidney involvement in HIV infection is multifactorial.…”

Section: Introductionmentioning

confidence: 99%