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Prevalence of renal dysfunction among HIV infected patients receiving Tenofovir at Mulago: a cross-sectional study.
BMC Nephrol. 2020 Jun 22; 21(1):232.BN

Abstract

BACKGROUND

There is an increasing burden of non-communicable disease globally. Tenofovir disoproxil fumarate (TDF) is the most commonly prescribed antiretroviral drug globally. Studies show that patients receiving TDF are more prone to renal dysfunction at some point in time during treatment. Evaluation of kidney function is not routinely done in most HIV public clinics. Identification of renal dysfunction is key in resource constrained settings because managing patients with end stage renal disease is costly.

METHOD

This was a cross-sectional study conducted at an outpatient clinic in 2018 involving patients on TDF for at least 6 months who were 18 years or older. Patients with documented kidney disease and pregnancy were excluded. Estimated glomerular filtration rate (eGFR) was calculated using the CKD-Epi formula. Renal dysfunction was defined as any of the following; either eGFR< 60 mL/min/1.73m2,or proteinuria of ≥2+ on urine dipstick, glycosuria with normal blood glucose. Electrolyte abnormalities were also documented.

RESULTS

We enrolled 278 participants. One hundred sixty nine (60.8%) were females, majority 234(84.2%) were < 50 years old, 205 (73.74%) were in WHO stage 1, most participants 271(97.5%) in addition to TDF were receiving lamivudine/efavirenz. The median age was 37(IQR 29-45) years; median duration on ART was 36 (IQR 24-60) months. The prevalence of renal dysfunction was 2.52% (7/278). Most noted electrolyte abnormality was hypocalcaemia (15.44%).

CONCLUSIONS

The prevalence of renal dysfunction was low though some participants had hypocalcaemia. Screening for kidney disease should be done in symptomatic HIV infected patients on TDF.

Authors+Show Affiliations

KCCA- directorate of public health, P.O. Box 7010, Kampala, Uganda. lnyende@gmail.com.School of Medicine, Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda.School of Medicine, Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda. Panorama medical centre, Kampala, Uganda.School of Medicine, Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32571236

Citation

Nyende, Louis, et al. "Prevalence of Renal Dysfunction Among HIV Infected Patients Receiving Tenofovir at Mulago: a Cross-sectional Study." BMC Nephrology, vol. 21, no. 1, 2020, p. 232.
Nyende L, Kalyesubula R, Sekasanvu E, et al. Prevalence of renal dysfunction among HIV infected patients receiving Tenofovir at Mulago: a cross-sectional study. BMC Nephrol. 2020;21(1):232.
Nyende, L., Kalyesubula, R., Sekasanvu, E., & Byakika-Kibwika, P. (2020). Prevalence of renal dysfunction among HIV infected patients receiving Tenofovir at Mulago: a cross-sectional study. BMC Nephrology, 21(1), 232. https://doi.org/10.1186/s12882-020-01873-y
Nyende L, et al. Prevalence of Renal Dysfunction Among HIV Infected Patients Receiving Tenofovir at Mulago: a Cross-sectional Study. BMC Nephrol. 2020 Jun 22;21(1):232. PubMed PMID: 32571236.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of renal dysfunction among HIV infected patients receiving Tenofovir at Mulago: a cross-sectional study. AU - Nyende,Louis, AU - Kalyesubula,Robert, AU - Sekasanvu,Emmanuel, AU - Byakika-Kibwika,Pauline, Y1 - 2020/06/22/ PY - 2018/11/03/received PY - 2020/05/26/accepted PY - 2020/6/24/entrez PY - 2020/6/24/pubmed PY - 2020/6/24/medline KW - Estimated glomerular filtration rate KW - Renal dysfunction KW - Tenofovir disproxil fumarate SP - 232 EP - 232 JF - BMC nephrology JO - BMC Nephrol VL - 21 IS - 1 N2 - BACKGROUND: There is an increasing burden of non-communicable disease globally. Tenofovir disoproxil fumarate (TDF) is the most commonly prescribed antiretroviral drug globally. Studies show that patients receiving TDF are more prone to renal dysfunction at some point in time during treatment. Evaluation of kidney function is not routinely done in most HIV public clinics. Identification of renal dysfunction is key in resource constrained settings because managing patients with end stage renal disease is costly. METHOD: This was a cross-sectional study conducted at an outpatient clinic in 2018 involving patients on TDF for at least 6 months who were 18 years or older. Patients with documented kidney disease and pregnancy were excluded. Estimated glomerular filtration rate (eGFR) was calculated using the CKD-Epi formula. Renal dysfunction was defined as any of the following; either eGFR< 60 mL/min/1.73m2,or proteinuria of ≥2+ on urine dipstick, glycosuria with normal blood glucose. Electrolyte abnormalities were also documented. RESULTS: We enrolled 278 participants. One hundred sixty nine (60.8%) were females, majority 234(84.2%) were < 50 years old, 205 (73.74%) were in WHO stage 1, most participants 271(97.5%) in addition to TDF were receiving lamivudine/efavirenz. The median age was 37(IQR 29-45) years; median duration on ART was 36 (IQR 24-60) months. The prevalence of renal dysfunction was 2.52% (7/278). Most noted electrolyte abnormality was hypocalcaemia (15.44%). CONCLUSIONS: The prevalence of renal dysfunction was low though some participants had hypocalcaemia. Screening for kidney disease should be done in symptomatic HIV infected patients on TDF. SN - 1471-2369 UR - https://www.unboundmedicine.com/medline/citation/32571236/Prevalence_of_renal_dysfunction_among_HIV_infected_patients_receiving_Tenofovir_at_Mulago:_a_cross-sectional_study L2 - https://www.biomedcentral.com/1471-2369/21/232 DB - PRIME DP - Unbound Medicine ER -
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