Marie Patrice Halle, Moussa Oumarou, Francois Kaze, Yacouba Mapoure, Hugo Mbatchou, Henry Luma
Department of Internal Medicine, Douala General Hospital; Faculty of Medicine and Pharmaceutical Sciences, University of Douala; Douala, Cameroon.
Iran J Kidney Dis. 2018 Oct;12(5):268-274.
Chronic kidney disease (CKD) is frequent amongst human immunodeficiency virus (HIV)-positive patients, and screening is not routinely performed in Sub-Saharan Africa due to resource constraints. We aimed to determine the prevalence of CKD and associated factors in HIV-infected patients in Cameroon.
A cross-sectional study in Northern Cameroon included HIV-positive patients who attended the HIV clinic. Patients with an estimated glomerular filtration rate less than 60 mL/min/1.73 m² or urinary abnormalities underwent a second measurement 3 months later. Glomerular filtration rate was estimated using the 4-variable Modification of Diet in Renal Disease (MDRD) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. Logistic regression was used to identify factors associated with CKD.
We included 709 participants. The median CD4 count was 219 cells/mL. Proteinuria accounted for 34.4%; leukocyturia, 6.9%; and hematuria, 6.1%. Prevalence of CKD was 44.4% (CKD-EPI) and 47.2% (MDRD). Stages 3 to 5 of CKD were documented in 11.6% using the CKD-EPI and 7.5% using the MDRD. Factors associated with CKD were an age greater than 35 years (odds ratio [OR], 104; 95% confidence interval [CI], 1.02 to 1.06), longer duration of HIV (OR, 2.60; 95% CI, 1.53 to 3.95), history of hepatitis B (OR, 3.04; 95% CI, 1.08 to 8.54), and CD4 cells less than 200 cells/mL (OR, 3.64; 95% CI, 2.55 to 5.21).
The prevalence of CKD is high among HIV patients in Cameroon. There is a need of implementing measures to encourage early detection of kidney disease in these patients.
慢性肾脏病（CKD）在人类免疫缺陷病毒（HIV）阳性患者中很常见，由于资源限制，撒哈拉以南非洲地区未常规开展筛查。我们旨在确定喀麦隆HIV感染患者中CKD的患病率及相关因素。
在喀麦隆北部进行的一项横断面研究纳入了到HIV门诊就诊的HIV阳性患者。估算肾小球滤过率低于60 mL/（min·1.73 m²）或存在尿液异常的患者在3个月后进行了第二次测量。采用4变量的肾脏病饮食改良（MDRD）公式和慢性肾脏病流行病学合作组织（CKD-EPI）公式估算肾小球滤过率。采用逻辑回归分析确定与CKD相关的因素。
我们纳入了709名参与者。CD4细胞计数中位数为219个/ mL。蛋白尿占34.4%；白细胞尿占6.9%；血尿占6.1%。CKD的患病率采用CKD-EPI公式为44.4%，采用MDRD公式为47.2%。使用CKD-EPI公式记录的CKD 3至5期为11.6%，使用MDRD公式为7.5%。与CKD相关的因素包括年龄大于35岁（比值比[OR]，1.04；95%置信区间[CI]，1.02至1.06）、HIV感染时间较长（OR，2.60；95% CI，1.53至3.95）、乙型肝炎病史（OR, 3.04；95% CI，1.08至8.54）以及CD4细胞低于200个/ mL（OR，3.64；95% CI，2.55至5.21）。
喀麦隆HIV患者中CKD的患病率很高。需要采取措施鼓励对这些患者进行肾病的早期检测。
