Descriptive study of the prevealence of renal dysfunction in HIV positive patients on highly active anti-retroviral therapy (HAART) and to relate abnormal renal function with urinalysis

Abstract

The high frequency with which elevated creatinine levels and proteinuria occur indicate the importance of closely monitoring serum and urine chemistries in HIV-infected patients, especially those with risk factors for renal dysfunction. 1.To describe the prevalence of renal dysfunction in patients on HAART. 2.To associate abnormal urinalysis and renal dysfunction. 3.To determine possible predictors for abnormal renal function in HIV positive patients on HAART.This research was a hospital based cross-sectional study of HIV positive adults who attended the University Teaching Hospital (UTH) in Lusaka, Zambia. Questionnaire was administered and specimens collected. All information was entered to an excel spreadsheet. Analysis was performed on all selected variables using SPSS software program. Student's t-test was used for continuous data and Chi-square for categorical variables to look at the level of significance (where indicated, Yates correction and Fisher's exact values were used). Logistic regression was used to determine the association of positive urinalysis results for level of GFR. The prevalence of renal dysfunction in our cohort of HIV infected patients on HAART was found to be 25 percent. That of HIV AN (HIV-associated Nephropathy) was assumed to be 14.8 percent based on improved renal function once commenced on HAART. The prevalence of proteinuria was about 60%. The possible predictors of abnormal renal function were found to be; age, BMI, CD4 count, Hypertension while ACE-Inhibitors appeared to be renoprotective. Renal failure is a significant co-morbid condition associated with HIV disease but is usually overlooked. The prevalence of renal dysfunction in our cohort of HIV infected patients on HAART was found to be 25 percent. That of HIV AN was assumed to be 14.8 percent based on improved renal function once commenced on HAART and after adjusting for other co-morbid conditions. The prevalence of proteinuria was found to be about 60%. Although there was some association between level of proteinuria and GFR, this was inconclusive as the numbers were too small for statistical significance.