dc.contributor.author | Kairu, Brian N | |
dc.date.accessioned | 2016-04-27T06:39:58Z | |
dc.date.available | 2016-04-27T06:39:58Z | |
dc.date.issued | 2015 | |
dc.identifier.uri | http://hdl.handle.net/11295/95105 | |
dc.description.abstract | Background: Availability of antiretroviral therapy has had a profound positive effect on
HIV/AIDS morbidity and mortality. Renal dysfunction is increasingly being recognized
amongst antiretroviral exposed and naïve people living with HIV/ AIDS. Renal dysfunction
is multifactorial and result from direct effects of the virus, some antiretroviral agents and
drugs used for prophylaxis and treatment of opportunistic infections. Chronic kidney disease
is expensive to treat besides being a strong independent risk factor for cardiovascular
diseases.CKD is associated with higher mortality and morbidity in people living with
HIV/AIDS
Objective: To determine the prevalence of chronic kidney disease among ambulatory
HIV/AIDS patients on antiretroviral therapy at Kenyatta National Hospital.
Methodology: This was a Cross sectional observational study conducted between July and
September 2014 that enrolled patients who were 18 years and above on HAART for at least
one year. We used a structured questionnaire for clinical and demographic data. Urine and
blood were collected from patients. Dipstick analysis and urine albumin and creatinine assay
were done in urine and creatinine assay in blood.Serum creatinine was used to calculate
estimated glomerular filtration rate using modified diet in renal disease formula. Association
between presence of chronic kidney disease and preselected risk factors such as hypertension,
diabetes mellitus,CD4+ count,age, HIV stage, prior tuberculosis treatment, duration of illness
and treatment.
Results: One hundred and fifty eight (158) patients were recruited. Average age was
43.3years with a range of 24-69 and 78.5% of the patients were female. Mean baseline CD4+
count was 212cells/ml(SD +/-174) and the most recent CD4+ was 496 cells/ml(SD +/-
242).Average duration since diagnosis of HIV was 5.7 years and that from ART initiation
was 4.8 years. Diabetes mellitus and hypertension was seen in 5.7% and 12% of patients
respectively. Evidence of chronic kidney disease was seen in 88% of patients ;17.6% had
estimated glomerular filtration rate less than 60mls/min 1.73 and 86.3% had albuminuria.No
preselected risk factors were found to have significant association with presence of CKD on
univariate analysis.
Prevalence of CKD in PLHA on HAART
Conclusion: There was a very high prevalence of CKD in patients on antiretroviral therapy
at. Majority of the patients had proteinuria. Prevalence of Reduced glomerular filtration was
high. No significant association was found between CKD and known risk factors assessed. | en_US |
dc.language.iso | en | en_US |
dc.publisher | University of Nairobi | en_US |
dc.rights | Attribution-NonCommercial-NoDerivs 3.0 United States | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/us/ | * |
dc.title | Prevalence of chronic kidney disease among ambulatory Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome patients on antiretroviral therapy at the Kenyatta National Hospital | en_US |
dc.type | Thesis | en_US |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |