title: Renal abnormalities among HIV infected children at Muhimbili National Hospital (MNH)-Dar es Salaam, Tanzania.
abstract: BACKGROUND
  Human Immunodeficiency Virus infection is a multisystem disease that contributes to significant morbidity. Renal involvement is reported to be common among patients with HIV. This study was carried out to determine renal involvement using simple bedside tests combined with ultrasonography examination.
  
  
  METHODS
  We recruited 240 children from the HIV clinic at Muhimbili National Hospital. Data were collected using structured questionnaires and included demographic, clinical information, radiological tests; renal ultrasound and laboratory tests; serum creatinine, white blood cells, CD4+ counts and percent, urine for microalbuminuria and proteinuria.
  
  
  RESULTS
  Microalbuminuria and proteinuria were present in 20.4 % and 7.1 % respectively. Significantly higher prevalence of microalbuminuria (p < 0.01) and proteinuria p < 0.01) were noted with low CD4 percent (<25 %). Lower mean CD4+ count were noted among children with microalbuminuria [937.4 ± 595.3 cells/μL vs 1164.7 ± 664.3 cell/μL, (p < 0.05)] and proteinuria [675.5 ± 352.3 cells/μL vs 1152 ± 662 cells/μL (p < 0.001)]. Fourteen (5.8 %) HIV infected children had estimated glomerular filtration rate (eGFR of 30-59) consistent with severe renal impairment. Increased cortical echogenicity was noted in 69/153 (39.2 %) of participants who had ultrasound examination.
  
  
  CONCLUSIONS
  Microalbuminuria, proteinuria and renal dysfunction were noted to be prevalent among HIV infected children indicating the need to consider routine screening of renal complications in these children.
authors.affiliation: Department of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), P. O. Box 65001, Dar es Salaam, Tanzania. fredrick.francis78@gmail.com.|Renal Unit, Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania. fredrick.francis78@gmail.com.
authors.forename: Francis
authors.initials: F
authors.lastname: Fredrick
authors.affiliation: National Institute of Medical Research (NIMR), Mwanza-Centre, Mwanza, Tanzania.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Francis
authors.affiliation: Renal Unit, Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania.|Department of Internal Medicine, School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania.
authors.forename: Paschal J
authors.initials: PJ
authors.lastname: Ruggajo
authors.affiliation: Department of Internal Medicine, School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania.
authors.forename: Eden E
authors.initials: EE
authors.lastname: Maro
mesh_terms: D000293:Adolescent; D000419:Albuminuria / Q000453:epidemiology*; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D005919:Glomerular Filtration Rate; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging* / Q000378:metabolism; D008297:Male; D015995:Prevalence; D011507:Proteinuria / Q000453:epidemiology; D051436:Renal Insufficiency, Chronic / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000378:metabolism; D013636:Tanzania / Q000453:epidemiology; D014463:Ultrasonography
chemical_list: D044966:Anti-Retroviral Agents; D003404:Creatinine