ABSTRACT
Abstract Introduction: Human immunodeficiency virus (HIV) the causative agent of Acquired immunodeficiency syndrome (AIDS) is an important cause of renal diseases in sub-Saharan Africa. There is paucity of studies on the burden of chronic kidney disease (CKD) among patients with HIV/AIDS in the North-Central zone of Nigeria. Methods: This is a cross-sectional study of 227 newly-diagnosed, antiretroviral naïve patients with HIV/AIDS seen at the HIV clinic of the Medical Out-patient Department (MOPD) of University of Ilorin Teaching Hospital (UITH). They were matched with 108 control group. Laboratory investigations were performed for the participants. CKD was defined as estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 and/or albumin creatinine ratio (ACR) > 30 mg/g. Results: There were 100 (44%) males among the patients and 47 (43.5%) among the control group. The mean ages of the patients and controls were 40.3 ± 10.3 years and 41.8 ± 9.5 years respectively. CKD was observed in 108 (47.6%) among the patients and 18 (16.7%) of the controls (p = 0.01). The median CD4 T-cell count was significantly lower in patients with CKD. Ninety-three (41.0%) of the patients had dipstick proteinuria of > 2 +. The median albumin creatinine ratio (ACR) was significantly higher among the HIV-positive patients (272.3 mg/g) compared with the HIV-negative controls (27.22 mg/g) p = 0.01. The CD4 T-cell count correlates positively with eGFR (r = 0.463, p = 0.001) and negatively with ACR (r = -0.806, p = 0.001). Conclusions: CKD is very common among patients with HIV/AIDS in Ilorin. Screening and early intervention for CKD should be part of the protocols in the management of these patients. .
Resumo Introdução: o vírus da imunodeficiência humana (HIV), o agente causador da síndrome da imunodeficiência adquirida (AIDS), é uma importante causa de doenças renais na África subsaariana. Há escassez de estudos sobre o impacto da doença renal crônica (DRC) em pacientes com HIV/AIDS na zona centronorte da Nigéria. Métodos: Este é um estudo transversal com 227 pacientes recém-diagnosticados com HIV/AIDS, não tratados com agentes antirretrovirais, atendidos no ambulatório de HIV do Hospital Universitário da Universidade de Ilorin (UITH). Eles foram pareados com 108 indivíduos do grupo controle. Os pacientes foram submetidos a investigações laboratoriais. A DRC foi definida como taxa estimada de filtração glomerular (eTFG) ≤ 60 ml/min/1,73m2 e/ou a relação entre albumina e creatinina (RAC) ≥ 30 mg/g Resultados: Houve 100 (44%) pacientes do sexo masculino entre os pacientes e 47 (43,5%) entre os indivíduos do grupo controle. As médias de idade dos pacientes e controles foram de 40,3 ± 10,3 anos e 41,8 ± 9,5 anos, respectivamente. A DRC foi observada em 108 indivíduos (47,6%) entre os pacientes e em 18 (16,7%) dos controles (p = 0,01). A contagem mediana de linfócitos T CD4 foi significativamente menor nos pacientes com DRC. Noventa e três (41,0%) dos pacientes tiveram proteinúria ≥ 2 + no exame de dipstick (tiras reagentes). A mediana da relação entre creatinina e albumina (RAC) foi significativamente maior entre os indivíduos HIV-positivos (272,3 mg/g), em comparação com os controles HIV negativos (27,22 mg/g) p = 0,01. A contagem de linfócitos T CD4 correlacionou-se positivamente com a eTFG (r = 0,463, p = 0,001) e negativamente com o RAC (r = -0,806, p = 0,001). Conclusões: DRC é muito comum entre os pacientes com HIV/AIDS em Ilorin. Triagem e intervenção precoce para DRC devem fazer parte dos protocolos de tratamento desses pacientes. .
Subject(s)
Humans , Male , Female , Adult , HIV Infections/complications , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/epidemiology , Cross-Sectional Studies , HIV Infections/diagnosis , Nigeria/epidemiology , PrevalenceABSTRACT
Background: The association of benign prostatic hypertrophy (BPH) and chronic kidney disease (CKD) has been a subject of controversies. Combinations of recurrent urinary tract infections, chronic retention with large residual urine volumes and decreased bladder compliance have been reported to be associated with chronic renal failure in patients with benign prostatic obstruction. Aims: To determine the estimated glomerular filtration rate (eGFR) and find out its relationship with the International Prostate Symptom Score (IPSS). Methodology: This is a cross-sectional study involving 129 new patients with benign prostatic hypertrophy. The severity and the degree of bother associated with patient’s lower urinary tract symptoms (LUTS) were assessed using the IPSS while the eGFR was determine using the modified Modification of Diets in Renal Disease. Results: Majority (38.8%) were in stage 2 CKD with eGFR of 60-89 ml/min/1.73 m2 and only 6(4.7%) patients were in stage 5 CKD with eGFR <15 ml/min/1.73 m2. Overall 55(42.7%) were found to have CKD at presentation. There was no statistically significant difference between the severity of lower urinary tract symptoms (LUTS) and eGFR. The most observed symptom was urinary frequency followed by urgency which were present in 95 (73.6%) and 82 (63.6%) respectively. There was a significant difference in the quality of life among patient with eGFR less than or greater than 60 ml/min/1.73m2 p = .005. Conclusion: This study demonstrated an association between BPH and CKD in men whose symptoms were bothersome (those with poor QoL). The degree of bothersomeness (QoL) could be used as the determinant for requesting serum creatinine to assess the renal status of patient with BPH. Estimation of GFR among these patients with BPH will offer a rapid method of renal function assessment at presentation and thus facilitate the application of clinical practice guidelines and clinical performance measures to improve the outlook of possible renal complication.