HIV-associated nephropathy in Saudi Arabia.
OBJECTIVE
Human immunodeficiency virus-associated nephropathy (HIVAN) is the most common cause of chronic renal failure in HIV patients with African descent. It usually presents with proteinuria, enlarged kidneys, and rapidly progressive renal failure, often over several weeks to months. We conducted this study to determine the prevalence of HIVAN in our HIV population.


METHODS
Cross-sectional observational study in a referral center covering the period of 1990- 2010.


METHODS
Proteinuria and estimated glomerular filtration rate (e-GFR) were used to identify renal disease and suspicious cases of HIVAN with abnormal proteinuria and e-GFR of < 60 mL/min/1.73 m2.


RESULTS
Of 585 HIV-positive patients, 248 were eligible to inclusion criteria. Most of the patients were male, that is, 165 (67%) were male compared to 83 (33%) female with the mean age 39 years; 240 (96.7%) were on antiretroviral therapy. Thirty (12%) patients had abnormal proteinuria and 218 (88%) had normal urinary protein and e-GFR. No significant differences were observed in demographic data, CD4+ T-lymphocyte count, viral load, creatinine level, and e-GFR among both groups. Significant differences were observed in the prevalence of diabetes mellitus in the abnormal proteinuria group (10 patients [33.3%] compared to 30 patients [13.8%] in the normal group (P=.0139) and the prevalence of hypertension in the abnormal proteinuria group (11 patients [36.7%] compared to 22 patients [10%] in the normal group (P=.002). Sixteen patients (6.6% of the cohort) met the study definition of HIVAN.


CONCLUSIONS
The prevalence of abnormal proteinuria and HIVAN among HIV-infected patients in Saudi Arabia is higher than that of non-African patients in developed countries.
Dr. Abdulrahman A. Alrajhi, Department of Medicine,, King Faisal Specialist Hospital and Research Centre,, MBC#46 PO Box 3354,, Riyadh 11211, Saudi Arabia, rajhi@kfshrc.edu.sa.
Haifa
H
Al-Sheikh
Mohammed
M
Al-Sunaid
Abdulrahman A
AA
Alrajhi
D016263:AIDS-Associated Nephropathy / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011507:Proteinuria / Q000453:epidemiology*; D012529:Saudi Arabia / Q000453:epidemiology; D019562:Viral Load; D055815:Young Adult