Erschienen in:
04.12.2015 | Original Article
Renal abnormalities in a cohort of HIV-infected children and adolescents
verfasst von:
Flávia Vanesca Felix Leão, Regina Célia de Menezes Succi, Daisy Maria Machado, Aída de Fátima Thomé Barbosa Gouvêa, Fabiana Bononi do Carmo, Suenia Vasconcelos Beltrão, Maria Aparecida de Paula Cançado, João Tomas de Abreu Carvalhaes
Erschienen in:
Pediatric Nephrology
|
Ausgabe 5/2016
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Abstract
Background
This study aimed to identify the prevalence of renal abnormalities and the evolution of glomerular filtration rate (GFR) among human immunodeficiency virus (HIV)- infected children and adolescents followed up in an infectious disease outpatient pediatric clinic.
Methods
We performed a cohort study of 115 children and adolescents. Outcomes of two evaluations for urinalysis, microalbuminuria/urinary creatinine ratio, urinary retinol-binding protein (uRBP) concentration, and estimated GFR (eGFR) were obtained for each patient, with an average interval of 6 months between evaluations. These changes were correlated with gender, age, race, body mass index (BMI), height-for-age (H/A) percentile, clinical and immunological classification of HIV infection, use of antiretroviral therapy (ART), HIV viral load (VL), and CD4+ T-lymphocyte count.
Results
Mean patient age at the time of inclusion in the study was 12.6 ± 3.2 years; 50.4 % were male, 81.7 % had acquired immune defeciency syndrome (AIDS), 80.9 % had CD4+ < 500 cells/mm3, and 87.8 % were on ART. Urinary changes included hematuria (11.3 %), proteinuria (7 %), and microalbuminuria (11.6 %); uRBP was present in 3.8 %; and mean eGFR was 163 ± 32 ml/min/1.73 m2.
Conclusions
The subclinical renal abnormalities found in this study may indicate early manifestations of a broad spectrum of renal dysfunction associated with HIV and involves the decision to initiate or modify ART.