CLINICAL STUDY OF ACUTE KIDNEY INJURY IN HIV INFECTED AND HIV UNINFECTED PATIENTS.

Kadam D.B; Suryawanshi N. R.; Sangle S.A; Redewad N.K

Volume : VIII, Issue : VII, July - 2019

CLINICAL STUDY OF ACUTE KIDNEY INJURY IN HIV INFECTED AND HIV UNINFECTED PATIENTS.

Kadam D. B, Suryawanshi N. R. , Sangle S. A, Redewad N. K

Abstract :

Acute kidney injury (AKI) is aupt decline in renal function, defined by increase in serum creatinine and /or reduced urine output. AKI in HIV patients is associated with opportunistic infections, drugs and immunosuppression. Although there are number of studies in relation with AKI in HIV infected and HIV uninfected patients, there is lack of comparative data. We studied first 30 HIV infected and 30 HIV uninfected patients admitted with AKI in medicine ward of a tertiary hospital, divided in two groups on the basis of HIV Elisa report. Patients with underlying chronic kidney disease were excluded. Data regarding etiological factors, clinical presentation, laboratory investigations, treatment given and their outcome at 1 week and 3 month later was noted and compared. Among the HIV negative patients, 25(83.33%) had pre–renal, six(20%) had renal, and four(13.33%) had post–renal cause. Whereas, among the HIV positive patients 13(43.33%) had pre–renal, 18(60%) had renal and five(16.66%) had post–renal cause. Some of these patients had overlap of pre renal and renal or renal and post renal causes.All 18 patients with renal AKI were on Tenofovir disoproxilbased regimen. All (7)HIV patients who died had CD4 less than 300cells/mm3. Median CD4 in survivors was 309cells/mm3 and in patients who died was 129cells/mm3. The two groups were comparable with respect to age and sex distribution, clinical features, creatinine levels and outcome. AKI in HIV patients is most commonly associated with infections and drugs. Low CD4 count is associated with poor outcome of AKI. However, large randomised studies are needed to determine the association between anti–retroviral drugs and AKI.