Spectrum of clinical presentations in human immunodeficiency virus (HIV) infected patients with renal disease

ABSTRACT

HIV infection is a multiorgan disease with the kidney not spared. A variety of renal syndromes with varying clinical presentations has been reported amongst HIV infected patients. This study aims to highlight the spectrum of clinical presentations in HIV infected patients with renal disease. HIV infected patients presenting at University of Benin Teaching Hospital (UBTH) Benin City were the study population. A total of 383 patients were studied. Their biodata; clinical presentations and laboratory investigations including serum urea; creatinine and albumin; urine protein and creatinine were assessed. Their glomerular filtration rate (GFR) and protein urine excretion were calculated using six equations of modification of diet in renal disease (MDRD) and protein creatinine ratio respectively. Patients were stratified according to their renal functions into normal; mild; moderate and severe renal function impairment. The data was analysed using statistical software program SPSS Vs 15.0. 53.3of 383 patients screened had renal function impairment; 40.2mild; 37.7moderate and 22.28.3 years for mild; 9.9 and 36.3 8.3; 36.0 severe impairment. Mean age was 35.6 moderate and severe renal function impairment (RFI) respectively. Easy fatigability was the commonest symptoms occurring in 47.5; 30.0; 37.5and 22.5of control; mild RFI; moderate RFI and severe RFI subjects respectively (p = 0.568). Oliguria; facial and body swelling occurred more in patients with RFI especially in patients with severe renal impairment. The difference is statistically significant (p = 0.046; 0.041; and 0.033 respectively). Pallor was the commonest clinical sign occurring in 32.5; 50.0; 35.0and 62.5of control and patients with mild; moderate; and severe RFI respectively; the difference was not statistically significant (p = 0.459). Ascites; facial puffiness and pedal oedema were commoner in patients with RFI especially those with severe RFI. The differences were statistically significant. (p = 0.048; 0.019; and 0.008 respectively). In conclusion spectrum of clinical presentations in HIV patients with renal impairment are many but few are specific to these patients