Kidney function of HIV-infected children in Lagos, Nigeria: using Filler's serum cystatin C-based formula.
BACKGROUND
Limited data is available on kidney function in HIV-infected children in sub-Saharan Africa. In addition, malnutrition in these children further reduces the utility of diagnostic methods such as creatinine-based estimates of glomerular filtration rate. We determined the serum cystatin C level and estimated glomerular filtration rate of 60 antiretroviral-naïve, HIV-infected children and 60 apparently healthy age and sex matched children.


METHODS
Serum cystatin C level was measured using enzyme-linked immunosorbent assay technique, while glomerular filtration rate was estimated using Filler's serum cystatin C formula. Student t test, Mann Whitney U test, Pearson chi square and Fisher's exact test were used, where appropriate, to test difference between groups.


RESULTS
Compared to the controls, the HIV-infected group had significantly higher median (interquartile range) serum cystatin C levels {0.77 (0.29) mg/l versus 0.66 (0.20) mg/l; p = 0.025} and a higher proportion of children with serum cystatin C level >1 mg/l {10 (16.7%) versus one (1.7%); p = 0.004}. The HIV-infected children had a mean (+/- SD) eGFR of 96.8 (+/- 36.1) ml/min/1.73 m2 compared with 110.5 (+/- 27.8) ml/min/1.73 m2 in the controls (p = 0.021). After controlling for age, sex and body mass index, only the study group (HIV infected versus control) remained a significant predictor of serum cystatin C level (beta = -0.216, p = 0.021). The proportion of HIV-infected children with eGFR <60 ml/min/1.73 m2 was eight (13.3%) versus none (0%) in the control group (p = 0.006). However, the serum cystatin C level, eGFR and proportions of children with serum cystatin C level >1 mg/l and eGFR <60 ml/min/1.73 m2 were not significantly different between the HIV-infected children with advanced disease and those with milder disease.


CONCLUSIONS
HIV-infected children in Nigeria have higher serum cystatin C level and lower eGFR compared to age and sex matched controls.
Esezobor
Christopher I
CI
Department of Paediatrics, University of Lagos and Lagos University Teaching Hospital, Idi-Araba, Nigeria. esezobor@gmail.com
Iroha
Edna
E
Oladipo
Olajumoke
O
Onifade
Elizabeth
E
Soriyan
Oyetunji O
OO
Akinsulie
Adebola O
AO
Temiye
Edamisan O
EO
Ezeaka
Chinyere
C
D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D055316:Cystatin C / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D015658:HIV Infections / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000175:diagnosis / Q000503:physiopathology*; D007677:Kidney Function Tests; D009549:Nigeria
D055316:Cystatin C