title: Renal abnormalities in a cohort of HIV-infected children and adolescents.
abstract: BACKGROUND
  This study aimed to identify the prevalence of renal abnormalities and the evolution of glomerular filtration rate (GFR) among human immunodeficiency virus (HIV)- infected children and adolescents followed up in an infectious disease outpatient pediatric clinic.
  
  
  METHODS
  We performed a cohort study of 115 children and adolescents. Outcomes of two evaluations for urinalysis, microalbuminuria/urinary creatinine ratio, urinary retinol-binding protein (uRBP) concentration, and estimated GFR (eGFR) were obtained for each patient, with an average interval of 6 months between evaluations. These changes were correlated with gender, age, race, body mass index (BMI), height-for-age (H/A) percentile, clinical and immunological classification of HIV infection, use of antiretroviral therapy (ART), HIV viral load (VL), and CD4+ T-lymphocyte count.
  
  
  RESULTS
  Mean patient age at the time of inclusion in the study was 12.6 ± 3.2 years; 50.4 % were male, 81.7 % had acquired immune defeciency syndrome (AIDS), 80.9 % had CD4+ < 500 cells/mm(3), and 87.8 % were on ART. Urinary changes included hematuria (11.3 %), proteinuria (7 %), and microalbuminuria (11.6 %); uRBP was present in 3.8 %; and mean eGFR was 163 ± 32 ml/min/1.73 m(2).
  
  
  CONCLUSIONS
  The subclinical renal abnormalities found in this study may indicate early manifestations of a broad spectrum of renal dysfunction associated with HIV and involves the decision to initiate or modify ART.
authors.affiliation: Pediatric Nephrology Division, Escola Paulista de Medicina-Universidade Federal de SãoPaulo, Rua Borges Lagoa, 442 Vl. Clementino, São Paulo, SP, CEP: 04038-030, Brazil.
authors.forename: Flávia Vanesca Felix
authors.identifier: http://orcid.org/0000-0002-0452-0535
authors.initials: FV
authors.lastname: Leão
authors.affiliation: Pediatric Infectious Disease Division, Escola Paulista de Medicina-Universidade Federal de SãoPaulo, São Paulo, Brazil. succi@picture.com.br.
authors.forename: Regina Célia
authors.initials: RC
authors.lastname: de Menezes Succi
authors.affiliation: Pediatric Infectious Disease Division, Escola Paulista de Medicina-Universidade Federal de SãoPaulo, São Paulo, Brazil.
authors.forename: Daisy Maria
authors.initials: DM
authors.lastname: Machado
authors.affiliation: Pediatric Infectious Disease Division, Escola Paulista de Medicina-Universidade Federal de SãoPaulo, São Paulo, Brazil.
authors.forename: Aída de Fátima Thomé Barbosa
authors.initials: Ade F
authors.lastname: Gouvêa
authors.affiliation: Pediatric Infectious Disease Division, Escola Paulista de Medicina-Universidade Federal de SãoPaulo, São Paulo, Brazil.
authors.forename: Fabiana Bononi
authors.initials: FB
authors.lastname: do Carmo
authors.affiliation: Pediatric Infectious Disease Division, Escola Paulista de Medicina-Universidade Federal de SãoPaulo, São Paulo, Brazil.
authors.forename: Suenia Vasconcelos
authors.initials: SV
authors.lastname: Beltrão
authors.affiliation: Pediatric Nephrology Division, Escola Paulista de Medicina-Universidade Federal de SãoPaulo, Rua Borges Lagoa, 442 Vl. Clementino, São Paulo, SP, CEP: 04038-030, Brazil.
authors.forename: Maria Aparecida
authors.initials: MA
authors.lastname: de Paula Cançado
authors.affiliation: Pediatric Nephrology Division, Escola Paulista de Medicina-Universidade Federal de SãoPaulo, Rua Borges Lagoa, 442 Vl. Clementino, São Paulo, SP, CEP: 04038-030, Brazil.
authors.forename: João Tomas
authors.initials: JT
authors.lastname: de Abreu Carvalhaes
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000419:Albuminuria / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D000554:Ambulatory Care Facilities; D058070:Asymptomatic Diseases; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016482:Urinalysis; D055815:Young Adult
keywords: Adolescents; Children; Human immunodeficiency virus; Hyperfiltration; Proteinuria; Renal dysfunction