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Title: Renal abnormalities in a cohort of HIV-infected children and adolescents
Authors: Leão, Flavia Vanesca Felix [UNIFESP]
Succi, Regina Célia de Menezes [UNIFESP]
Machado, Daisy Maria [UNIFESP]
Gouvea, Aida de Fatima Thome Barbosa [UNIFESP]
Carmo, Fabiana Bononi do [UNIFESP]
Beltrao, Suenia Vasconcelos [UNIFESP]
Cançado, Maria Aparecida de Paula [UNIFESP]
Carvalhaes, Joo Tomas de Abreu [UNIFESP]
Keywords: Children
Human immunodeficiency virus
Renal dysfunction
Issue Date: 2016
Publisher: Springer
Citation: Pediatric Nephrology. New York, v. 31, n. 5, p. 773-778, 2016.
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.
ISSN: 0931-041X
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