Urine Abnormalities and Chronic Kidney Disease in Highly Active Antiretroviral Therapy-naive Adults: A Cross-sectional Study

Abstract

Objective: This study investigated chronic kidney disease (CKD) and urine abnormalities in highly active antiretroviral therapy naïve (HAART-naïve) human immunodeficiency virus (HIV) infected adults, presenting to two antiretroviral therapy (ART) clinics in the Volta region of Ghana. Methods: A cross-sectional study of 100 newly diagnosed HIV/AIDS patients attending ART clinics of the St. Anthony’s and Ho Municipal hospitals both in the Volta region was conducted. Vital clinical history and socio-demographic data were recorded from the folder of eligible participants. Blood and urine samples were collected for serum creatinine estimation; urinalysis was performed with dipstick and light microscopy. CKD was assessed with the Kidney Disease Improving Global Outcome (KDIGO) guidelines. Results: Nine percent (9%) of the participants had CKD (eGFR<60 mL/min/1.73 m2). Prevalence of CKD was higher (88.9%) in females than in males (11.1%). Median creatinine levels were significantly higher in males than in females (P=0.0103). Eighteen percent (18%), 13%, 11% of the participants had proteinuria, pyuria and haematuria respectively. On urine microscopy, we recorded 8% (8/100) crystalluria (7/8 -calcium oxalate and 1/8 -triple phosphate), 9% epithelial cells, 20% pus cells and 7% red blood cells among our participants. Participants with confirmed CKD had more pyuria and haematuria than those without CKD.  Conclusion: This study revealed a 9% prevalence of CKD among our participants with the condition being more common in females. Urine abnormalities like proteinuria, haematuria, pyuria and crystalluria were common in our participants. Routine urinalysis and screening for CKD in HIV/AIDS patients should be strengthened as it will help in early detection of renal abnormalities.