title: Renal manifestations of HIV infected highly active antiretroviral therapy naive children in India.
abstract: BACKGROUND
  There are several studies on renal manifestations in human immunodeficiency virus (HIV) infected children from American and African regions, but similar studies from India are lacking. A cross-sectional study was carried out in 28 HIV infected antiretroviral therapy (ART) naïve children coming to the pediatric HIV clinic.
  
  
  METHODS
  Demographic data of the children, clinical presentations including blood pressure, detailed laboratory investigations (serum creatinine, glomerular filtration rate), urine analysis (urine morphology, urine albumin, pus cells, and red blood cells), and CD4 counts were collected.
  
  
  RESULTS
  Of the 28 children, 15 (53.6%) had renal manifestations with a male to female ratio of 1:1.5. The most common renal manifestation in our study was abnormal glomerular filtration rate (GFR) in 11 (44.0%) of 25 children. This was followed by pus cells in urine in 6 (21.4%) of the 28 children while 3 (10.7%) of them had proteinuria. The mean age of children with renal manifestations was 5.04±2.75 years as compared to those without renal manifestations who had a mean age of 7.38±2.95 years (P=0.0390). CDC class and sex were not associated with renal manifestations.
  
  
  CONCLUSIONS
  Our study suggests that reduced GFR is the common renal manifestation, particularly in younger children. Other renal manifestations are related to proteinuria. The lack of correlation of CDC classification with renal manifestations mandates screening of children with HIV for renal disease. A more detailed study of renal manifestations in HIV-infected children is needed.
authors.affiliation: Department of Pediatric HIV, B.J. Wadia Hospital for Children, Mumbai, India. irashah@pediatriconcall.com
authors.forename: Ira
authors.initials: I
authors.lastname: Shah
authors.forename: Shradha
authors.initials: S
authors.lastname: Gupta
authors.forename: Dhaval M
authors.initials: DM
authors.lastname: Shah
authors.forename: Harshal
authors.initials: H
authors.lastname: Dhabe
authors.forename: Mamatha
authors.initials: M
authors.lastname: Lala
mesh_terms: D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007674:Kidney Diseases / Q000453:epidemiology / Q000821:virology*; D008297:Male; D016482:Urinalysis