Prevalence of Renal Dysfunction and Its Relationship to CD4 and TNF Alpha of HIV Positive Individuals on Anti-retroviral Therapy in Port Harcourt

Abstract

Background: Despite the success of anti-retroviral drugs, renal impairment remains one of the most significant complications of HIV. This study aimed to evaluate the prevalence of renal impairment and its association with age, gender, CD4 and TNF alpha of HIV positives in the University of Port Harcourt Teaching Hospital (UPTH). Materials and Methods: This hospital-based, cross- sectional study recruited 397 HIV positive patients on Anti-retroviral therapy for at least 6 months in the UPTH HIV clinic between June and August 2016. These patients were randomly selected from a cluster of patients attending the HIV clinic in UPTH. Using patient’s folders, age and gender were obtained while blood samples were collected for TNF and CD4 analysis. Estimated glomerular filtration rate was calculated using a modification of diet in Renal Disease –MDRD formula Results: Prevalence of renal impairment was estimated at 12.7% based on MDRD equation. Females recorded the significantly high prevalence of renal dysfunction at 11.84%. CD4 57.45± 15.33 Cells/μl and TNF alpha 38.51± 22.40 pg/ml were significantly low in patients with renal dysfunction. EGFR correlated negatively with CD4 and TNF alpha. Conclusion: The prevalence of renal dysfunction was low in this study. Reduced serum TNF alpha level and CD4 count are associated with renal dysfunction. Therefore, age and CD4 may be considered as the predictors of renal dysfunction. Also, female patients in this study may be at risk of renal dysfunction.