ASSESSMENT OF RENAL FUNCTION IN HIV/AIDS PATIENTS ON HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) IN ABUTH, ZARIA
ASSESSMENT OF RENAL FUNCTION IN HIV/AIDS PATIENTS ON HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) IN ABUTH, ZARIA
No Thumbnail Available
Date
2009-10
Authors
RASHEED, YUSUF
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Acquired immunodeficiency syndrome (AIDS) is a spectrum of disease states
characterised by progressive immunosuppression. It results from infection with
Human Immunodeficiency Virus (HIV) which is capable of affecting every
organ system in the body. Renal complications are important component of
advanced HIV disease, and these complications significantly contribute to
morbidity and mortality in these patients. Therefore regular assessment of their
renal status using sensitive markers such as Creatinine Clearance (CrCl)
together with serum electrolytes, creatinine, urea and uric acid is necessary.
The objective of this study was therefore to assess the renal function, determine
the appropriate assessment parameters and the prevalence of renal disease
among HIV/AIDS patients on highly active antiretroviral therapy (HAART) in
ABUTH, Zaria. Renal function of 101 HIV positive patients on HAART and
100 controls was assessed. The data obtained were analysed using statistical
programme for the social sciences 11.0 (SPSS 11.0).Two-tailed student׳s
t-test
r matched samples and Pearson’s linear correlation statistical methods were
employed for the analysis. A p-value of equal to or less than 0.05 (p≤ 0.05) was
considered as statistically significant.
Mean levels of Na+, K+, HCO3-, Cl-, Ca2+ and PO42- obtained in patients were
138.97±0.43, 3.83±0.05, 25.28±0.26, 100.02±0.42, 2.62±0.03 and 1.21±0.03
mmol/L respectively, whereas the corresponding values in controls were
138.84±0.26, 3.96±0.04, 25.78±0.16, 98.90±0.35, 2.31±0.02 and 1.22±0.02
mmol/L respectively. These results showed that K+ was significantly lower (p<
0.05) while Cl- and Ca2+ were significantly higher (p< 0.05 and p< 0.001
respectively) in patients than in controls. Also the mean levels of estimated
creatinine clearance (eCrCl), creatinine, uric acid and urea in patients were
121.52±4.95 ml/min, 65.29±2.61 µmol/L, 258.62±8.32 µmol/L and 4.27±0.20
mmol/L respectively, whereas the corresponding values in controls were
121.04±2.62, 74.46±1.33, 204.00±5.35 and 5.02±0.09 respectively. These
results showed that creatinine and urea were significantly lower (p< 0.01) while
uric acid was significantly higher (p< 0.001) in patients than in controls. This
study demonstrated that all analytes in both patients and controls were within
normal reference ranges for this environment.
The study also showed that 26 (25.7%) patients had decreased eCrCl as against
12 (12.0%) controls. Nineteen (18.8%) of the patients with decreased eCrCl had
eCrCl of < 90 ml/min (stage 2 CKD) with the remaining 7 (6.9%) having eCrCl
of <60 ml/min (stage 3 CKD). Of all the patients with deranged renal function
using eCrCl, only 4 would have been detected using serum creatinine with or
without proteinuria.
It was also found that 48(47.5%) of the patients were overweight to mild obesity
as against 26 (26.0%) controls.
The findings in this study demonstrates a higher prevalence of renal disease in
patients and that eCrCl is a better marker than serum electrolytes, urea,
creatinine and uric acid in assessing renal function in these patients. It is
therefore recommended that GFR should be assessed regularly using prediction
formula (Cockcroft and Gault formula) in HIV/AIDS patients on HAART.
Description
A THESIS SUBMITTED TO THE POSTGRADUATE SCHOOL,
AHMADU BELLO UNIVERSITY, ZARIA, IN PARTIAL FULFILMENT
FOR THE AWARD OF MASTER OF SCIENCE DEGREE IN
CHEMICAL PATHOLOGY
DEPARTMENT OF CHEMICAL PATHOLOGY, FACULTY OF
MEDICINE, AHMADU BELLO UNIVERSITY, ZARIA
OCTOBER, 2009
Keywords
ASSESSMENT,, RENAL,, FUNCTION,, HIV,, AIDS,, PATIENTS,, HIGHLY,, ACTIVE,, ANTIRETROVIRAL,, THERAPY,, HAART,, ABUTH,, ZARIA,