Serum electrolytes and renal alterations in HIV-seropositive Mexican subjects

Abstract

To examine potential risk factors associated with biochemical alterations in renal function in a population diagnosed with HIV/AIDS undergoing antiretroviral treatment. This is an observational, transversal, and relational design study that included 179 HIV-seropositive subjects. Glucose serum, cholesterol, triglycerides, total proteins, albumin, creatine, urea, blood urea nitrogen (BUN), and electrolytes levels were determined for each individual. Renal function was evaluated through the glomerular filtration rate (GFR), using the CKD-EPI equation. Chronic kidney disease (CKD) was defined as estimated glomerular filtration rate < 60 mL/min/1.73 m 2 . Univariate model significant variables, with a 95% confidence interval (CI), were included in a multivariate logistic regression analysis. CKD prevalence in patients was 7.3%, with comorbidities of 7.8% for type 2 diabetes mellitus, 7.3% for arterial hypertension, and 35.2% for dyslipidemia. Additionally, both hypernatremia and hypophosphatemia were detected in 57% (n = 102) of the patients. Multivariate logistic regression suggested that CD4+ T cell count < 200 ( P = .02; OR 0.2; CI 95% 0.08–0.8) was associated to hyponatremia; similarly, detectable viral load was associated to hypokalemia ( P = .02; OR 5.1; CI 95% 1.2–21.3), hypocalcemia ( P = .01; OR 4.1; CI 95% 1.3–12.3), and hypermagnesemia (OR 3.9; CI 95% 1.1–13.6). Patient age was associated to both hypophosphatemia ( P = .01; OR 2.4; CI 95% 1.1–5.0) and hypermagnesemia ( P = .01; OR 2.8; IC 95% 1.1–7.0), and high creatinine levels were associated to nucleoside reverse transcriptase inhibitor treatment ( P = .001; OR 42.5; CI 95% 2.2–806.9). Lastly, high BUN levels were associated to age ( P = .03; OR 3.8; CI 95% 1.0–14.4), while GFR 60 to 89 mL/min/1.73 m 2 was associated to dyslipidemia ( P = .02; OR 2.2; CI 95% 1.1–4.5). CD4+ T cell and viral load were the main factors associated with renal biochemical alterations.

Hypertension and human immunodeficiency virus: A paradigm for epithelial sodium channels?

“…Hyperkalemia and hypokalemia are common in HIV, although their impact on renal salt handling and ENaC remains unexplored. For example, commonly used drugs such as Amphotericin B to treat cryptococcal meningitis in HIV, chronic diarrhea, AIDS-associated enteropathies as well as detectable HIV mRNA levels were associated with hypokalemia ( 52 – 54 ). Conversely, hyperkalemia has been seen with the use of high-dose trimethoprim-sulfamethoxazole or intravenous pentamidine for pneumocystis jirovecii pneumonia attributed to an amiloride-like mechanism by blocking apical membrane sodium channels in the mammalian distal nephron ( 55 – 57 ).…”

The effect of highly active antiretroviral therapy on the urea and creatinine of HIV/AIDS patients in Enugu Southeast of Nigeria

“…Urea is the byproduct of protein metabolism, it is been synthesized from ammonia by liver enzyme of the urea cycle and then excreted by the kidney, it is not actively reabsorbed nor secreted by the tubules but it is freely filtered by the glomeruli, some factors affecting urea level includes; malnutrition, increased protein intake, pregnancy, cirrhosis, use of steroid [20]. Kidney disease prevalence in subjects with HIV infection is reported between 3.5% and 48.5% [15,17], this affects their ability to filter waste and toxins as it ought to and has cause a remarkable change in the creatinine and urea level of HIV patient [21].…”