title: Acute kidney injury in HIV-infected children: comparison of patients according to the use of highly active antiretroviral therapy.
abstract: OBJECTIVE
  To assess clinical and laboratory data, and acute kidney injury (AKI) in HIV-infected children using and not using highly active antiretroviral therapy (HAART) prior to admission.
  
  
  METHODS
  A retrospective study was conducted with HIV-infected pediatric patients (<16 years). Children who were using and not using HAART prior to admission were compared.
  
  
  RESULTS
  Sixty-three patients were included. Mean age was 5.3±4.27 years; 55.6% were females. AKI was observed in 33 (52.3%) children. Patients on HAART presented lower levels of potassium (3.9±0.8 vs. 4.5±0.7mEq/L, p=0.019) and bicarbonate (19.1±4.9 vs. 23.5±2.2mEq/L, p=0.013) and had a higher estimated glomerular filtration rate (102.2±36.7 vs. 77.0±32.8mL/min/1.73m2, p=0.011) than those not on HAART. In the multivariate analysis, the use of HAART prior to the admission was a protective factor for AKI (p=0.036; OR=0.30; 95% CI=0.097-0.926).
  
  
  CONCLUSIONS
  AKI is a common complication of pediatric HIV infection. Use of HAART prior to the admission preserved glomerular filtration and was a protective factor for AKI, but increased medication side effects, such as hypokalemia and renal metabolic acidosis.
authors.affiliation: Universidade Federal do Ceará (UFC), Faculdade de Medicina, Departamento de Medicina Interna, Fortaleza, CE, Brazil.
authors.forename: Douglas de Sousa
authors.initials: DS
authors.lastname: Soares
authors.affiliation: Universidade Federal do Ceará (UFC), Faculdade de Medicina, Departamento de Medicina Interna, Fortaleza, CE, Brazil.
authors.forename: Malena Gadelha
authors.initials: MG
authors.lastname: Cavalcante
authors.affiliation: Universidade Federal do Ceará (UFC), Faculdade de Medicina, Departamento de Medicina Interna, Fortaleza, CE, Brazil.
authors.forename: Samille Maria Vasconcelos
authors.initials: SM
authors.lastname: Ribeiro
authors.affiliation: Universidade Federal do Ceará (UFC), Faculdade de Medicina, Departamento de Medicina Interna, Fortaleza, CE, Brazil.
authors.forename: Rayana Café
authors.initials: RC
authors.lastname: Leitão
authors.affiliation: Universidade Federal do Ceará (UFC), Faculdade de Medicina, Departamento de Medicina Interna, Fortaleza, CE, Brazil.
authors.forename: Ana Patrícia Freitas
authors.initials: AP
authors.lastname: Vieira
authors.affiliation: Universidade Federal do Ceará (UFC), Faculdade de Medicina, Departamento de Medicina Interna, Fortaleza, CE, Brazil.
authors.forename: Roberto da Justa
authors.initials: RD
authors.lastname: Pires Neto
authors.affiliation: Universidade de Fortaleza (UNIFOR), Faculdade de Medicina, Centro de Ciências da Saúde, Fortaleza, CE, Brazil.
authors.forename: Geraldo Bezerra da
authors.initials: GB
authors.lastname: Silva Junior
authors.affiliation: Universidade Federal do Ceará (UFC), Faculdade de Medicina, Departamento de Medicina Interna, Fortaleza, CE, Brazil. Electronic address: ef.daher@uol.com.br.
authors.forename: Elizabeth de Francesco
authors.initials: EF
authors.lastname: Daher
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications*; D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000379:methods*; D001639:Bicarbonates / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007223:Infant; D008297:Male; D011188:Potassium / Q000097:blood; D020011:Protective Agents / Q000009:adverse effects; D012189:Retrospective Studies
chemical_list: D001639:Bicarbonates; D020011:Protective Agents; D011188:Potassium
keywords: Acute kidney injury; Children; Crianças; HAART; HIV; Insuficiência renal aguda; TARV