Renal dysfunction in HIV-infected patients commencing antiretroviral therapy in a treatment centre in southern Nigeria

Abstract

Objective: As HIV becomes a more manageable chronic condition, with increasing life expectancy and an ageing population, kidney disease due to HIV or antiretroviral therapy (ART) have become more prominent. Moreover, the nephrotoxic potential of some frontline antiretroviral drugs has become established. The study aimed to evaluate the prevalence and risk factors for renal dysfunction among HIV-infected patients commencing ART at a southern Nigerian tertiary hospital. Methods: A cross-sectional prospective study involving 263 HIV-infected treatment-naïve patients commencing ART at the University of Port Harcourt Teaching Hospital, Port Harcourt. Blood and urine samples were taken from randomly recruited patients for appropriate laboratory analysis. The MDRD formulae were used for evaluating renal function while renal dysfunction was defined as an estimated glomerular filtration rate ≤ 60mls/min/1.73m2 and /or proteinuria. Results: The average age of enrolled patients was 36.3±10.15 with 59.3% women. 33.8% had proteinuria and 6.5% had eGFR 50 years, anaemia and use of Traditional medicine were independent predictors of renal dysfunction. Conclusion: In this cohort of treatment naïve HIV patients, a high prevalence of renal dysfunction exists. Older age, anaemia and traditional medicine use were predictors of renal dysfunction. There is a need for clinicians to monitor these variables, especially the use of Traditional medicine which is easily overlooked in practice.

Keywords

• HIV
• Renal dysfunction
• Traditional medicine
• Antiretroviral Therapy
• Proteinuria