RENAL FUNCTION IN CHILDREN WITH HIV INFECTION SEEN AT THE UNIVERSITY OF ILORIN TEACHING HOSPITAL, ILORIN

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RENAL FUNCTION IN CHILDREN WITH HIV INFECTION SEEN AT THE UNIVERSITY OF ILORIN TEACHING HOSPITAL, ILORIN

Abstract

The kidney is a common target in HIV infection and a significant proportion of
patients with HIV infection have varying degree of renal dysfunction during the
course of the disease. This study was carried out to evaluate renal function in
HIV infected children seen at UITH.
This was a descriptive, prospective case control study that of HIV infected
children aged 6weeks to 12 years. Socio-demographic, clinical and laboratory
data were obtained. Schwartz formular was used to determine the glomerular
filteration rate.
A total of 71 HIV infected children and 71 HIV uninfected children were
recruited into the study. There were 33males and 38 females giving a
male:female ratio of 1:1.2. The mean age of the subjects and controls were
comparable (p =0.966).
The mean of the estimated glomerular filteration rate in the subjects was
96.0±18.8mls/min/1.73m2 compared to 97.8±11.5mls/min/1.73m2in the controls
and the difference was not significant (p =0.506). However the prevalence of
significant reduction in estimated GFR was 2.8% in the subjects while none of
the controls had this abnormality. The prevalence of proteinuria and haematuria
was 28.2% and 4.2% respectively in the subjects while it was 5.6% and 2.8%
respectively in the controls. Proteinuria was significantly higher in the subjects
than in the controls (p =0.001).Mean serum sodium and potassium levels were
significantly lower in the subjects (p <0.05)with a prevalence of 35.2% for
xix
hyponatraemia and 5.6% for hypokalaemia in the subjects. Hyponatraemia was
higher in the subjects (p=0.001) and none of the control had hypokalaemia. The
mean serum urea and creatinine were similar in both subjects and controls.
There was no significant relationship observed between the estimated GFR and
both the CD4+ counts and level of immunosuppression. A significant
correlation was observed between significant reduction in GFR and stage of the
disease in the subjects (p=0.001).Similarly a significant negative correlation
was found between proteinuria and the CD4+ counts levels while there was a
positive correlation between proteinuria and the level of immunosuppression
and worsening clinical stage of the disease (each p< 0.05).The use of
antiretroviral drugs did not significantly affect the parameters of renal
dysfunction.
In conclusion, though the overall GFR was normal, the prevalence of other
parameters of renal dysfunction was high among HIV infected children,
especially in those with advanced disease and immunosuppression. Renal status
should be assessed in all HIV infected children in order to forestall progression
to end stage renal disease, especially in an environment where resources are
limited for renal replacement therapy.

RENAL FUNCTION IN CHILDREN WITH HIV INFECTION SEEN AT THE UNIVERSITY OF ILORIN TEACHING HOSPITAL, ILORIN

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