Renal dysfunction in HIV positive patients on highly active antiretroviral therapy (HAART)

Abstract

BACKGROUND: The use of HAART has turned HIV/AIDS into a chronic disease and people live longer. They now present with complications related to the treatment, ageing process and the virus itself. Renal dysfunction is a recognized complication in HIV infected patients on HAART and can present as acute kidney injury or chronic kidney disease. METHODS: A cross sectional study was conducted at Parirenyatwa Hospital on patients receiving HAART. Inclusion criteria were age ≥ 18 years and provision of an informed consent. Clinical data was recorded. Body mass index, CD4 count, serum creatinine, urine for dipstick proteinuria and protein: creatinine ratio was collected. Creatinine was calculated using the Cockcroft-Gault formula. Renal dysfunction was defined as Creatinine clearance (CrCl)< 60mL/min. RESULTS: A total of 122 patients with complete data were analysed. 69% were females. Mean age of patients was 37.7 ±11.3 years and Body mass index was26.0 ±5.2 kg/m². Renal dysfunction defined as CrCl< 60mL/min was found in 18.9 %,(n =23/122). Microalbuminuria was found to be a risk factor for renal dysfunction [OR 4.24 95% CI 1.00-17.04] p < 0.049. CONCLUSION: Renal dysfunction is common among patients on HAART and micro albuminuria is a risk factor for developing renal dysfunction. For patients on HAART routine urine protein: creatinine ratio and calculation of creatinine clearance should be done at regular intervals to monitor if the patients are developing renal dysfunction.