Sub-Saharan Africa has the largest burden of paediatric HIV infection and renal disease is a major cause of morbidity and mortality
in these children.
Materials and Methods:
This cross-sectional study was carried out at the Federal Medical Centre (FMC) Owerri between January and June 2015. It assessed
renal function by determining the estimated GFR (eGFR) in HIV infected children and comparing it with that of apparently healthy
age and sex matched HIV negative controls. Schwartz formula was used to estimate the glomerular filtration rates.
Results:
105 HAART naïve and 104 children on HAART were recruited consecutively and 209 matched for age and sex HIV negative
children were involved in the study.
The mean eGFR of the HIV infected subjects (115.27±19.75ml/min/1.73m²) was, significantly lower than that of HIV negative
children (127.63±27.77ml/min/1.73m). The mean eGFR was significantly lower in the clinical and immunological advanced stages
(106.93±19.97ml/min/1.73m and 110.54±19.80ml/min/1.73m respectively) when compared to that observed in the non-advanced
stages (116.56±19.75ml/min/1.73m² and 117.46±19.75ml/min/1.73m² respectively). In addition, the mean eGFR was higher in the
subjects on HAART (118.37±19.79ml/min/1.73m) than that observed in the HAART naïve subjects (115.27±19.74ml/min/1.73m²).
Conclusion:
This study showed that HIV infected children had decreased estimated GFR .Assessing renal function routinely would facilitate
early detection and hence intervention thereby delaying progression to end stage renal disease in HIV infected children. This is
important in a setting like ours where there are limited resources for renal replacement.