Cargando…
Clinical characteristics and outcome of HIV infected patients with chronic kidney disease in Sub Saharan Africa: an example from in Cameroon
BACKGROUND: Chronic kidney disease (CKD) is one of the major complications of Human immune deficiency Virus (HIV) and a risk factor for poor outcome of these patients. We aimed to describe the profile and outcome of HIV positive patients with CKD in Douala general hospital in Cameroon. METHODS: HIV...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6617860/ https://www.ncbi.nlm.nih.gov/pubmed/31288761 http://dx.doi.org/10.1186/s12882-019-1446-3 |
_version_ | 1783433788076851200 |
---|---|
author | Halle, Marie Patrice Essomba, Noel Djantio, Hilaire Tsele, Germaine Fouda, Hermine Luma, Namme Henri Ashuntantang, Enow Gloria Kaze, Folefack Francois |
author_facet | Halle, Marie Patrice Essomba, Noel Djantio, Hilaire Tsele, Germaine Fouda, Hermine Luma, Namme Henri Ashuntantang, Enow Gloria Kaze, Folefack Francois |
author_sort | Halle, Marie Patrice |
collection | PubMed |
description | BACKGROUND: Chronic kidney disease (CKD) is one of the major complications of Human immune deficiency Virus (HIV) and a risk factor for poor outcome of these patients. We aimed to describe the profile and outcome of HIV positive patients with CKD in Douala general hospital in Cameroon. METHODS: HIV positive patients with CKD referred to the nephrologist from January 2007 to March 2013 were included. Socio demographic, clinical (history and stage of HIV, comorbidities, baseline nephropathy, used of c-ART), para clinical data at referral (serum urea, creatinine, full blood count, CD4 count, serum calcium, phosphorus, albumin), dialysis initiation and outcome at 1 year were collected from medical records. GFR was estimated using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. CKD was defined and classified according to the Kidney Disease Improving Global Outcomes (KDIGO 2012). RESULTS: We included 156 patients (51.3% men) with a mean age of 45.4 ± 12.1 years. Hypertension (36.5%), diabetes (17.9%) and Hepatitis C (7.7%) were the main comorbidities. HIV associated nephropathy (27.6%), chronic glomerulonephritis (15.4%) diabetes (14.1%) and hypertension (13.5%) were the leading causes of kidney disease. Before referral HIV status was known by 109 (69.9%) patients, with 76 (69.7%) being on c-ART. Median CD(4) count was 241 (117–438) cells/mm(3). Prevalence of anemia (93.9%), hypocalcemia (68.6%) and Proteinuria (77.6%) was high, 94 (60.3%) patients were at CKD stage 5 at referral and 37 (23.7%) underwent emergency dialysis. After 1 year, 64 (41.0%) patients were lost to follow up. The mortality rate was 49% and 25 (28.7%) were maintenance hemodialysis, and being on c-ART was associated with a lower risk of death (HR: 0.45; 95% CI: 0.23–0.89; p = 0.021). CONCLUSION: HIV patients with CKD were referred late with high morbidity and need for urgent hemodialysis. HIVAN was the main etiology of CKD and mortality rate was high mainly due to the absence of c-ART at referral. |
format | Online Article Text |
id | pubmed-6617860 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-66178602019-07-22 Clinical characteristics and outcome of HIV infected patients with chronic kidney disease in Sub Saharan Africa: an example from in Cameroon Halle, Marie Patrice Essomba, Noel Djantio, Hilaire Tsele, Germaine Fouda, Hermine Luma, Namme Henri Ashuntantang, Enow Gloria Kaze, Folefack Francois BMC Nephrol Research Article BACKGROUND: Chronic kidney disease (CKD) is one of the major complications of Human immune deficiency Virus (HIV) and a risk factor for poor outcome of these patients. We aimed to describe the profile and outcome of HIV positive patients with CKD in Douala general hospital in Cameroon. METHODS: HIV positive patients with CKD referred to the nephrologist from January 2007 to March 2013 were included. Socio demographic, clinical (history and stage of HIV, comorbidities, baseline nephropathy, used of c-ART), para clinical data at referral (serum urea, creatinine, full blood count, CD4 count, serum calcium, phosphorus, albumin), dialysis initiation and outcome at 1 year were collected from medical records. GFR was estimated using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. CKD was defined and classified according to the Kidney Disease Improving Global Outcomes (KDIGO 2012). RESULTS: We included 156 patients (51.3% men) with a mean age of 45.4 ± 12.1 years. Hypertension (36.5%), diabetes (17.9%) and Hepatitis C (7.7%) were the main comorbidities. HIV associated nephropathy (27.6%), chronic glomerulonephritis (15.4%) diabetes (14.1%) and hypertension (13.5%) were the leading causes of kidney disease. Before referral HIV status was known by 109 (69.9%) patients, with 76 (69.7%) being on c-ART. Median CD(4) count was 241 (117–438) cells/mm(3). Prevalence of anemia (93.9%), hypocalcemia (68.6%) and Proteinuria (77.6%) was high, 94 (60.3%) patients were at CKD stage 5 at referral and 37 (23.7%) underwent emergency dialysis. After 1 year, 64 (41.0%) patients were lost to follow up. The mortality rate was 49% and 25 (28.7%) were maintenance hemodialysis, and being on c-ART was associated with a lower risk of death (HR: 0.45; 95% CI: 0.23–0.89; p = 0.021). CONCLUSION: HIV patients with CKD were referred late with high morbidity and need for urgent hemodialysis. HIVAN was the main etiology of CKD and mortality rate was high mainly due to the absence of c-ART at referral. BioMed Central 2019-07-09 /pmc/articles/PMC6617860/ /pubmed/31288761 http://dx.doi.org/10.1186/s12882-019-1446-3 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Halle, Marie Patrice Essomba, Noel Djantio, Hilaire Tsele, Germaine Fouda, Hermine Luma, Namme Henri Ashuntantang, Enow Gloria Kaze, Folefack Francois Clinical characteristics and outcome of HIV infected patients with chronic kidney disease in Sub Saharan Africa: an example from in Cameroon |
title | Clinical characteristics and outcome of HIV infected patients with chronic kidney disease in Sub Saharan Africa: an example from in Cameroon |
title_full | Clinical characteristics and outcome of HIV infected patients with chronic kidney disease in Sub Saharan Africa: an example from in Cameroon |
title_fullStr | Clinical characteristics and outcome of HIV infected patients with chronic kidney disease in Sub Saharan Africa: an example from in Cameroon |
title_full_unstemmed | Clinical characteristics and outcome of HIV infected patients with chronic kidney disease in Sub Saharan Africa: an example from in Cameroon |
title_short | Clinical characteristics and outcome of HIV infected patients with chronic kidney disease in Sub Saharan Africa: an example from in Cameroon |
title_sort | clinical characteristics and outcome of hiv infected patients with chronic kidney disease in sub saharan africa: an example from in cameroon |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6617860/ https://www.ncbi.nlm.nih.gov/pubmed/31288761 http://dx.doi.org/10.1186/s12882-019-1446-3 |
work_keys_str_mv | AT hallemariepatrice clinicalcharacteristicsandoutcomeofhivinfectedpatientswithchronickidneydiseaseinsubsaharanafricaanexamplefromincameroon AT essombanoel clinicalcharacteristicsandoutcomeofhivinfectedpatientswithchronickidneydiseaseinsubsaharanafricaanexamplefromincameroon AT djantiohilaire clinicalcharacteristicsandoutcomeofhivinfectedpatientswithchronickidneydiseaseinsubsaharanafricaanexamplefromincameroon AT tselegermaine clinicalcharacteristicsandoutcomeofhivinfectedpatientswithchronickidneydiseaseinsubsaharanafricaanexamplefromincameroon AT foudahermine clinicalcharacteristicsandoutcomeofhivinfectedpatientswithchronickidneydiseaseinsubsaharanafricaanexamplefromincameroon AT lumanammehenri clinicalcharacteristicsandoutcomeofhivinfectedpatientswithchronickidneydiseaseinsubsaharanafricaanexamplefromincameroon AT ashuntantangenowgloria clinicalcharacteristicsandoutcomeofhivinfectedpatientswithchronickidneydiseaseinsubsaharanafricaanexamplefromincameroon AT kazefolefackfrancois clinicalcharacteristicsandoutcomeofhivinfectedpatientswithchronickidneydiseaseinsubsaharanafricaanexamplefromincameroon |