Prevalence of chronic kidney disease in newly diagnosed patients with Human immunodeficiency virus in Ilorin, Nigeria.

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.

Prevalence of Chronic Kidney Disease in newly diagnosed patients with Human immunodeficiency virus in Ilorin, Nigeria / A prevalência de doença renal crônica em pacientes recentemente diagnosticados com o vírus da imunodeficiência humana em llorin, Nigéria

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. .