title: The influence of HIV and schistosomiasis on renal function: a cross-sectional study among children at a hospital in Tanzania.
abstract: BACKGROUND
  Schistosomiasis and HIV are both associated with kidney disease. Prevalence and factors associated with abnormal renal function among HIV-infected children in Africa compared to uninfected controls have not been well described in a schistosomiasis endemic area.
  
  
  RESULTS
  This cross-sectional study was conducted at the Sekou Toure Regional Hospital HIV clinic in Mwanza, Tanzania. A total of 122 HIV-infected children and 122 HIV-uninfected siblings were consecutively enrolled. Fresh urine was obtained for measurement of albuminuria and Schistosoma circulating cathodic antigen. Blood was collected for measurement of serum creatinine. Estimated glomerular filtration rate (eGFR) was calculated using the modified Schwartz equation. Renal dysfunction was defined operationally as eGFR<60 mL/min/1.73 m2 and/or albuminuria>20 mg/L in a single sample. Among 122 HIV-infected children, 61/122 (50.0%) met our criteria for renal dysfunction: 54/122 (44.3%) had albuminuria>20 mg/L and 9/122 (7.4%) had eGFR<60. Among 122 HIV-uninfected children, 51/122 (41.8%) met our criteria for renal dysfunction: 48/122 (39.3%) had albuminuria>20 mg/L and 6/122 (4.9%) had eGFR<60. Schistosomiasis was the only factor significantly associated with renal dysfunction by multivariable logistic regression (OR = 2.51, 95% CI 1.46-4.31, p = 0.001).
  
  
  CONCLUSIONS
  A high prevalence of renal dysfunction exists among both HIV-infected Tanzanian children and their HIV-uninfected siblings. Schistosomiasis was strongly associated with renal dysfunction.
authors.affiliation: Department of Pediatrics, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania.
authors.forename: Neema M
authors.initials: NM
authors.lastname: Kayange
authors.affiliation: Department of Pediatrics, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania; Center for Global Health, Weill Cornell Medical College, New York, New York, United States of America.
authors.forename: Luke R
authors.initials: LR
authors.lastname: Smart
authors.affiliation: Center for Global Health, Weill Cornell Medical College, New York, New York, United States of America; Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, New York, United States of America.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Downs
authors.affiliation: Department of Pediatrics, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania.
authors.forename: Mwanaisha
authors.initials: M
authors.lastname: Maskini
authors.affiliation: Center for Global Health, Weill Cornell Medical College, New York, New York, United States of America; Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, New York, United States of America.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Fitzgerald
authors.affiliation: Department of Pediatrics, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania; Center for Global Health, Weill Cornell Medical College, New York, New York, United States of America; Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, New York, United States of America.
authors.forename: Robert N
authors.initials: RN
authors.lastname: Peck
mesh_terms: D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D015658:HIV Infections / Q000503:physiopathology*; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D012552:Schistosomiasis / Q000503:physiopathology*; D013636:Tanzania / Q000453:epidemiology