Abstract |
We determined the prevalence of renal impairment and possible HIV-associated nephropathy (HIVAN) in adults with World Health Organization (WHO) stages I or II HIV, presenting to the antiretroviral therapy (ART) clinic in a central hospital in Malawi. We enrolled 526 ART-naïve subjects, 67% women, median age 34 (17-73) years and mean CD4 count 305 (3-993) cells/μL. Blood pressure, weight, urine dipstick and microscopy, CD4 cell count and serum creatinine were measured. Creatinine clearance (CrCL) was estimated using the Cockcroft-Gault equation. Possible HIVAN was diagnosed based on levels of proteinuria and CrCl. In all, 23.3% had proteinuria (≥ 1+). 57.4% had reduced CrCl (< 90 mL/minute): 18.8% had moderate (CrCl 30-59 mL/minute) and 2.2% severe (CrCl <30 mL/minute) renal dysfunction. Extrapolating from renal biopsy studies that confirmed HIVAN, the proportion of patients with HIVAN in our clinic ranges from 1.8-21.2%. We conclude that renal impairment was common, though rarely severe, among HIV-infected adults with clinically non-advanced HIV disease. Renal dysfunction has been demonstrated to be a risk factor for (early) mortality. These results are relevant for ART programmes, such as those in Malawi, where renal function is not routinely assessed.
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Authors | G M Struik, R A den Exter, C Munthali, D Chipeta, J J G van Oosterhout, J L Nouwen, T J Allain |
Journal | International journal of STD & AIDS
(Int J STD AIDS)
Vol. 22
Issue 8
Pg. 457-62
(Aug 2011)
ISSN: 1758-1052 [Electronic] England |
PMID | 21795419
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- AIDS-Associated Nephropathy
(diagnosis, epidemiology, urine)
- Adolescent
- Adult
- Aged
- CD4 Lymphocyte Count
- Chi-Square Distribution
- Creatinine
(urine)
- Cross-Sectional Studies
- Female
- Glomerular Filtration Rate
- Humans
- Logistic Models
- Malawi
(epidemiology)
- Male
- Middle Aged
- Prevalence
- Prospective Studies
- Proteinuria
(epidemiology, urine)
- Renal Insufficiency
(diagnosis, epidemiology, urine, virology)
- Risk Factors
- Surveys and Questionnaires
- Young Adult
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