Anyabolu Ernest Ndukaife
Division of Nephrology, Department of Medicine, Imo State University Teaching Hospital, Orlu, Nigeria; Division of Nephrology, Federal Medical Centre, Owerri, Nigeria.
Pan Afr Med J. 2016 Nov 4;25:139. doi: 10.11604/pamj.2016.25.139.10580. eCollection 2016.
Human immunodeficiency virus (HIV) infection is a global healthcare problem. Some diseases and physiological states may be altered in HIV-infected individuals. Our objective was to evaluate urine creatinine and factors that influence urine creatinine in treatment-naïve HIV subjects in Nigeria.
This was a cross-sectional study involving treatment-naïve HIV subjects in a tertiary hospital in Nigeria. Creatinine in spot and 24-hour urine samples and other relevant investigations were performed. Low urine creatinine or dilute urine was defined as 24-hour urine creatinine (24HUCr) <300mg, normal urine creatinine as 24HUCr 300-3000mg and high urine creatinine or concentrated urine as 24HUCr>3000mg.Theassociation of low urine creatinine and high urine creatinine with potential risk factors was determined.
The mean spot urine creatinine (SUCr) of the treatment-naïve HIV subjects was 137.21± 98.47(mg/dl), minimum value 13.3mg/dl, maximum value 533.3mg/dl and range of values 520.0mg/dl. The mean 24HUCr was 1507±781mg, minimum value 206mg, maximum value 4849mg and range of values 4643mg. Twenty four-hour urine creatinine<300mg was observed in 2(0.5%) subjects, normal 24HUCr 300-3000mgin 349(93.1%) subjects and 24HUCr>3000mg in 24(6.4%) subjects. There was significant association between 24HUCr and serum low density lipoprotein cholesterol (LDL),serum high density lipoprotein cholesterol (HDL). There was high correlation between 24HUCr>3000mg and 24-hour urine osmolality (24HUOsm) (r=0.95), body mass index (BMI) (r=0.74), CD4 cells count (r=-0.71), serum HDL (r=-0.73).
The prevalence of dilute urine and concentrated urine was low. Twenty-four hour urine osmolality. BMI, CD4 cells count and HDL were strong correlates of high urine creatinine. Lipid abnormalities were common in treatment-naïve HIV subjects with high urine creatinine. There is need for clinicians to routinely conduct urine creatinine and further search for abnormalities of serum lipids, weight changes, depressed immunity and anemia in HIV subjects with dilute or concentrated urine in the early stages of the infection.
人类免疫缺陷病毒（HIV）感染是一个全球性的医疗保健问题。HIV感染个体的某些疾病和生理状态可能会发生改变。我们的目的是评估尼日利亚未接受过治疗的HIV感染者的尿肌酐及影响尿肌酐的因素。
这是一项横断面研究，涉及尼日利亚一家三级医院中未接受过治疗的HIV感染者。对即时尿样和24小时尿样中的肌酐以及其他相关检查进行了检测。低尿肌酐或稀释尿定义为24小时尿肌酐（24HUCr）<300mg，正常尿肌酐为24HUCr 300 - 3000mg，高尿肌酐或浓缩尿为24HUCr>3000mg。确定了低尿肌酐和高尿肌酐与潜在危险因素之间的关联。
未接受过治疗的HIV感染者的即时尿肌酐（SUCr）平均值为137.21±98.47（mg/dl），最小值为13.3mg/dl，最大值为533.3mg/dl，值域为520.0mg/dl。24小时尿肌酐平均值为1507±781mg，最小值为206mg，最大值为4849mg，值域为4643mg。2名（0.5%）受试者的24小时尿肌酐<300mg，349名（93.1%）受试者的24HUCr为正常的300 - 3000mg，24名（6.4%）受试者的24HUCr>3000mg。24HUCr与血清低密度脂蛋白胆固醇（LDL）、血清高密度脂蛋白胆固醇（HDL）之间存在显著关联。24HUCr>3000mg与24小时尿渗透压（24HUOsm）（r = 0.95）、体重指数（BMI）（r = 0.74）、CD4细胞计数（r = -0.71）、血清HDL（r = -0.73）之间存在高度相关性。
稀释尿和浓缩尿的患病率较低。24小时尿渗透压、BMI、CD4细胞计数和HDL与高尿肌酐密切相关。高尿肌酐的未接受过治疗的HIV感染者中脂质异常较为常见。临床医生有必要对HIV感染者在感染早期出现稀释尿或浓缩尿的情况常规检测尿肌酐，并进一步排查血脂异常、体重变化、免疫抑制和贫血等情况。
