Structural and functional kidney abnormalities in patients with Human immunodeficiency virus infection: A cross-sectional perspective.

Background: Chronic kidney disease is a progressive disease that evolves towards the development of end-stage renal disease. The superimposition of renal impairment on a complex disease, namely human immunodeficiency virus (HIV) infection, will raise the burden of comorbidities and, predict worse outcomes in this group of the population.

Aim: To evaluate the structural and functional defects of kidney in patients with HIV infection.

Methods: This cross-sectional study involved 227 patients with HIV infection. Participants were selected by simple random sampling method. Eligible participants included HIV infection-positive adults aged 18 years and above. Exclusion criteria encompassed individuals with preexisting hypertension, diabetes mellitus, chronic kidney disease, chronic liver disease, and those receiving nephrotoxic drugs. Informed consent was obtained. Data collection involved recording medical histories, conducting clinical examinations, and performing baseline blood investigations and ultrasonography to assess renal function and structural abnormalities.

Results: The mean age of participants was 41 years. Females constituted 66.5%; 78% were on Tenofovir-based regimen. The mean duration of HIV infection was 5 years; mean duration of antiretroviral therapy was 4 years. 67.4% had a body mass index over 25. World Health Organization staging of HIV infection revealed that 41.9% were in stage 3, 30% in stage 2. 35.7% had cluster differentiation 4 counts < 200. The mean creatinine was 1 mg/dL and mean urea was 25.1 mg/dL. 54.6% had estimated glomerular filtration rate of < 60. Enlarged kidneys in 39.2% and increased echogenicity in 82.8% of participants. A decline in estimated glomerular filtration rate and an increase in kidney size was significantly associated with advancing HIV stages.

Conclusion: Both structural and functional kidney abnormalities are common in patients with HIV infection. These abnormalities increase with disease progression, underscoring the need for regular and consistent renal monitoring.