Renal function, urinalysis abnormalities and correlates among HIV-infected cameroonians naive to antiretroviral therapy

Abstract

As per guidelines and recommendations, screening for renal diseases should be performed at the time of diagnosis of human immuno-deficiency virus (HIV) infection; however, this remains largely unimplemented in many settings across Sub-Saharan Africa. We evaluated the renal function, urinalysis abnormalities and their correlates in HIV-infected individuals who were naïve to highly active antiretroviral therapy (HAART). This was a cross-sectional study of 2 months′ duration involving 104 HIV-infected outpatients naive to HAART (71 women, 68%) attending the HIV clinic of the Yaoundé General Hospital in Cameroon. Renal and urinalysis parameters were measured and the Student t-test and Fischer exact test were used to compare the groups of participants. The mean age and CD4 count were, respectively, 35 ± 10.7 years and 305 ± 202/mL. Fifty-six (54%) patients presented with stages 3 and 4 of HIV infection. Forty-three (41%) patients had urinalysis abnormalities, including proteinuria (36%), leukocyturia (13%) and hematuria (12%). Proteinuria was associated with increased age, advanced stage of HIV infection, decreased CD4 count, hematuria and renal failure (P <0.04). Hematuria and leukocyturia were associated with decreased CD4 count and advanced stage of HIV infection, respectively (P = 0.04). The mean estimated glomerular filtration (eGFR) rate was100.2 ± 32.7 mL/min; three (3%) patients had renal failure (eGFR <60 mL/min) and 45 (43%) patients had reduced kidney function 60 ≤eGFR ≤90 mL/min. There was a high prevalence of decreased kidney function and proteinuria among Cameroonian HIV-infected patients naïve to HAART. Indicators of the severity of HIV infection, including advanced stage and low CD4 count, were associated with urinalysis abnormalities.