Acute kidney injury in patients with human immunodeficiency virus infection

Prakash, Jai; Gupta, T. K.; Prakash, Suraj; Rathore, Surendra Singh; Usha, .; Sunder, Shyam

doi:10.4103/0971-4065.138696

Cited by 19 publications

(16 citation statements)

References 25 publications

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“…We found that ATN was the most common cause of AKI with septic ATN as the dominant cause in the case of HIVinfected patients whereas ischaemic ATN predominated in the HIV-negative patients. This finding was comparable to other studies [17,27,29]. Prakash services is at their peripheral hospitals where treatment, such as a fluid challenge, is initiated.…”

Section: Discussionsupporting

confidence: 89%

In-hospital mortality of HIV-positive patients with acute kidney injury a decade after the roll-out of anti-retroviral therapy in Cape Town, South Africa

Chothia

Ramsunder

2019

AJN

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Background: Acute kidney injury (AKI) in HIV-infected patients in sub-Saharan Africa is a common cause of hospitalisation and is associated with high morbidity and mortality. There is a paucity of comparative data regarding the outcomes of AKI in those patients with and without HIV infection from the African continent. Methods: This was a single-centre retrospective study of all consecutive adult patients with AKI referred to the renal unit at Tygerberg Hospital for the period January 2015 to December 2016. The diagnosis of AKI required evidence of the following: a recent normal serum creatinine and/or normal kidney sizes on ultrasound examination and/or granular casts on urine microscopy. Kaplan-Meier curves and logistic regression were used to assess survival and identify factors predicting mortality. Results: We identified a total of 291 patients with AKI of whom 116 (40%) were HIV positive. HIV-positive patients had a mortality rate of 34.5% vs. 29.1% in the HIV-negative patients (P = 0.34). At hospital admission, HIV-positive patients had a higher admission serum creatinine (551 μmol/L vs. 190 μmol/L, P < 0.01). Of those who died, the HIV-positive patients were younger (41 vs. 52 years, P < 0.01), predominantly Black (87.5% vs. 23.5%, P < 0.01) and were mostly admitted to medical wards (92.5% vs. 41.2%, P < 0.01). There was no difference in mortality related to the use of renal replacement therapy (P = 0.50). Logistic regression identified mixed ancestry (OR 2.47, P = 0.02), HIV infection (OR 2.69, P < 0.01) and surgical ward admission (OR 2.05, P = 0.03) as predictors of death. Conclusions: In-hospital mortality of AKI was high, and HIV infection was associated with a greater risk of death. This may be the result of late presentation of both the AKI as well as the HIV infection.

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Section: Discussionsupporting

confidence: 89%

In-hospital mortality of HIV-positive patients with acute kidney injury a decade after the roll-out of anti-retroviral therapy in Cape Town, South Africa

Chothia

Ramsunder

2019

AJN

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“…The only prospective study was an observational analysis of AKI in HIV-seropositive adults[22]. AKI was noted in 138/3540 (3.9%) patients and in most cases was AKIN stage II (42.1%) or III (48.5%).…”

Section: Infectious Diseasesmentioning

confidence: 99%

Causal relationship between hypoalbuminemia and acute kidney injury

Wiedermann¹,

Wiedermann²,

Joannidis³

2017

WJN

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Our meta-analysis published in 2010 provided evidence that low levels of serum albumin (hypoalbuminemia) are a significant independent predictor of acute kidney injury (AKI) and death following AKI. Since then, a large volume of additional data from observational clinical studies has been published further evaluating the relationship between serum albumin and AKI occurrence. This is an updated review of the literature to re-evaluate the hypothesis that hypoalbuminemia is independently associated with increased AKI risk. Eligible studies published from September 2009 to December 2016 were sought in PubMed (MEDLINE) and forty-three were retained, the great majority being retrospective observational cohort studies. These included a total of about 68000 subjects across a diverse range of settings, predominantly cardiac surgery and acute coronary interventions, infectious diseases, transplant surgery, and cancer. Appraisal of this latest data set served to conclusively corroborate and confirm our earlier hypothesis that lower serum albumin is an independent predictor both of AKI and death after AKI, across a range of clinical scenarios. The body of evidence indicates that hypoalbuminemia may causally contribute to development of AKI. Furthermore, administration of human albumin solution has the potential to prevent AKI; a randomized, controlled study provides evidence that correcting hypoalbuminemia may be renal-protective. Therefore, measurement of serum albumin to diagnose hypoalbuminemia may help identify high-risk patients who may benefit from treatment with exogenous human albumin. Multi-center, prospective, randomized, interventional studies are warranted, along with basic research to define the mechanisms through which albumin affords nephroprotection.

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“…Similarly, Franceschini et al [17] showed that the ARF was associated with an infectious cause in 52% of cases. According to Prakash et al, the factors of hypo-infusion and renal ischemia factors are the main causes of ARF in India [21]. Infectious causes and water losses were also the main risk factors for the occurrence of ARF in HIV-infected patients in our Togo series.…”

Section: Discussionmentioning

confidence: 51%

Acute Renal Failure in Hospitals in Togo: Comparative Analysis of HIV Positive Patients and HIV Negative Patients

Tsevi¹,

Bawe²,

Nemi³

et al. 2019

OJNeph

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Introduction: Human Immunodeficiency (HIV) is a risk factor often associated with the occurrence of Acute Renal Failure (ARF). Objectives: To describe the profile of Acute Renal Failure (ARF) in HIV-infected patients and compare them to non-infected patients. Patients and Methods: It was a prospective study from January 2018 to February 2019 that took place in the nephrology, infectious diseases and internal medicine departments of the Sylvanus Olympio University Hospital Center in Lomé (Togo). Results: The prevalence of ARF in HIV-infected patients was 48.07%. HIV-infected patients had an average age of 46.9 ± 11.6 years (p = 0.36) compared to 44.0 ± 20.4 years for non-HIV infected patients. Female sex was predominant in the HIV-infected population with a sex ratio H/F of 0.6 (p < 0.0001) versus 2.9 for the non-infected. The reasons for admission were such as fever (28%), digestive disorders (56%) were more common in HIV-infected patients than non-infected patients (11.1%, 37%). Infected patients had more diarrhea than non-infected patients (24% versus 7.4%) with p = 0.01. They showed more signs of infections than uninfected patients (40% versus 18.5%) with P = 0.02. HIV infection was known before admission in 96% of cases. Patients whose HIV was known before admission had hypertension (16.7%), diabetes (12.5%) and CD4 count < 200 (/mm 3) in 50% of cases. HIV infected patients had more anemia (52.0% versus 22.2%) with p = 0.002. Conclusion: No deaths were recorded in the HIV-infected group.

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Acute kidney injury in patients with human immunodeficiency virus infection

Cited by 19 publications

References 25 publications

In-hospital mortality of HIV-positive patients with acute kidney injury a decade after the roll-out of anti-retroviral therapy in Cape Town, South Africa

In-hospital mortality of HIV-positive patients with acute kidney injury a decade after the roll-out of anti-retroviral therapy in Cape Town, South Africa

Causal relationship between hypoalbuminemia and acute kidney injury

Acute Renal Failure in Hospitals in Togo: Comparative Analysis of HIV Positive Patients and HIV Negative Patients

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