Okafor U H, Unuigbe E I, Ojogwu L I, Oviasu E, Wokoma F S
Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria.
Afr Health Sci. 2011 Aug;11 Suppl 1(Suppl 1):S28-33. doi: 10.4314/ahs.v11i3.70067.
HIV related renal disease is a common occurrence in patients with HIV infection. It is the third leading cause of end stage renal disease among African-American males between the ages of 20 and 64 years in USA. Renal function impairment has been reported at all stages of HIV infection. The aim of this study is to determine the relationship between severity of renal function impairment and CD4 cell count in HIV infected patients.
HIV patients presenting at University of Benin Teaching Hospital Benin, City Nigeria from 1(st) January to 30(th) June 2007 were randomly selected and screened for renal functional impairment (RFI). Those with RFI detected by glomerular filtration rate < 60 ml/min/1.73 m(2) or urine protein creatinine ratio 3 200 were stratified into mild, moderate and severe RFI. Forty patients from each stratum and forty HIV infected patients with normal renal functions were recruited as subjects and control respectively. Their clinical and laboratory parameters were evaluated. The data obtained were analysed using SPSS vs 15.0.
Of the HIV patients screened, 53.3% had renal functional impairment. of these, 40.2% had mild, 37.7% had moderate and 22.2% had severe impairment in their renal functions respectively Their mean age was 36.0 ± 8.8 years. The CD4 cell count was found to be 309.75 ± 268.71/ul, 188.45 ± 173.12/ul, and 141.10 ± 126.01/ul among subjects with mild, moderate and severe RFI respectively. The CD4 cell count in control group was 319.05 ± 248.41/ul. The difference was statistically significant. (p = <0.001). CD4 cell count had a significant positive correlation with GFR (r = 0.32, p = 0.042). However, there was a negative correlation between CD4 cell count and proteinuria but this was not statistically significant (r = 0.09, p = 0.173).
Severity of RFI has a positive correlation with degree of immunosuppression in HIV infected patients.
HIV相关肾病在HIV感染患者中很常见。在美国20至64岁的非裔美国男性中，它是终末期肾病的第三大主要病因。在HIV感染的各个阶段均有肾功能损害的报道。本研究的目的是确定HIV感染患者肾功能损害的严重程度与CD4细胞计数之间的关系。
随机选择2007年1月1日至6月30日在尼日利亚贝宁城贝宁大学教学医院就诊的HIV患者，并对其进行肾功能损害（RFI）筛查。那些通过肾小球滤过率<60 ml/min/1.73 m²或尿蛋白肌酐比≥200检测出RFI的患者被分为轻度、中度和重度RFI。分别从每个分层中选取40名患者以及40名肾功能正常的HIV感染患者作为研究对象和对照组。对他们的临床和实验室参数进行评估。使用SPSS 15.0对获得的数据进行分析。
在接受筛查的HIV患者中，53.3%存在肾功能损害。其中，分别有40.2%、37.7%和22.2%的患者肾功能为轻度、中度和重度损害。他们的平均年龄为36.0±8.8岁。轻度、中度和重度RFI患者的CD4细胞计数分别为309.75±268.71/μl、188.45±173.12/μl和141.10±126.01/μl。对照组的CD4细胞计数为319.05±248.41/μl。差异具有统计学意义（p =<0.001）。CD4细胞计数与肾小球滤过率呈显著正相关（r = 0.32，p = 0.042）。然而，CD4细胞计数与蛋白尿之间呈负相关，但无统计学意义（r = 0.09，p = 0.173）。
HIV感染患者中RFI的严重程度与免疫抑制程度呈正相关。
