title: Prevalence of low estimated glomerular filtration rate, proteinuria, and associated risk factors among HIV-infected black patients using Cockroft-Gault and modification of diet in renal disease study equations.
abstract: OBJECTIVE
  To evaluate the prevalence of low estimated glomerular filtration rate (eGFR), proteinuria, and associated risk factors among HIV-infected black patients at primary health care.
  
  
  METHODS
  A cross-sectional screening involving consecutive HIV-infected patients 18 years and older was done. Eighty-eight percent of patients were receiving highly active antiretroviral therapy (94% on first-line regimen: zidovudine + lamivudine + nevirapine). Simplified Modification of Diet in Renal Disease Study and Cockroft-Gault (CG) equations were used to estimate glomerular filtration rate and creatinine clearance, respectively. Determinants of dipstick proteinuria and low kidney function (<60 mL·min(-1)·1.73 m(-2)) were assessed using multivariate logistic regression analysis.
  
  
  RESULTS
  Three hundred HIV-infected (231 females) patients were screened. Their mean age, duration of HIV, and CD4(+) count were 43 ± 9 years, 33 ± 27 months, and 397 ± 224 cells per cubic millimeter, respectively. The prevalence of low eGFR according to Modification of Diet in Renal Disease Study and CG equations was 3% and 10%, respectively. Proteinuria was observed in 20.5% of patients. Only CD4(+) cell count ≤200 cells per cubic millimeter emerged as a strong determinant of low CG creatinine clearance [adjusted odds ratio (OR) 3.03; 95% confidence interval (CI): 1.099 to 8.352], whereas age ≥45 years (adjusted OR 3.69; 95% CI: 1.756 to 7.787), familial history of diabetes mellitus (adjusted OR 2.20; 95% CI: 1.067 to 4.543), and hypertension (adjusted OR 3.07; 95% CI: 1.278 to 7.787) were significantly associated with proteinuria.
  
  
  CONCLUSIONS
  Low eGFR and proteinuria are prevalent among these HIV-infected persons. Immunodeficiency emerged as one of the strongest determinants of renal impairment. This finding emphasizes the importance of highly active antiretroviral therapy in tackling the burden of chronic kidney disease in African HIV population.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, University of Kinshasa Hospital, University of Kinshasa, Democratic Republic of Congo.
authors.forename: Augustin L
authors.initials: AL
authors.lastname: Longo
authors.forename: Francois B
authors.initials: FB
authors.lastname: Lepira
authors.forename: Ernest K
authors.initials: EK
authors.lastname: Sumaili
authors.forename: Jean Robert R
authors.initials: JR
authors.lastname: Makulo
authors.forename: Henri
authors.initials: H
authors.lastname: Mukumbi
authors.forename: Justine B
authors.initials: JB
authors.lastname: Bukabau
authors.forename: Vieux M
authors.initials: VM
authors.lastname: Mokoli
authors.forename: Patrick K
authors.initials: PK
authors.lastname: Kayembe
authors.forename: Nazaire M
authors.initials: NM
authors.lastname: Nseka
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D044383:Black People; D018791:CD4 Lymphocyte Count; D003223:Congo / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005247:Feeding Behavior; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011507:Proteinuria / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D019380:Anti-HIV Agents