Acute kidney injury in HIV-infected children: comparison of patients according to the use of highly active antiretroviral therapy
Objective: To assess clinical and laboratory data, and acute kidney injury (AKI) in HIV-infected children using and not using highly active antiretroviral therapy (HAART) prior to admission. Methods: A retrospective study was conducted with HIV-infected pediatric patients (<16 years). Children wh...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2016-11-01
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| Series: | Jornal de Pediatria |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0021755716301036 |
| _version_ | 1798004723143409664 |
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| author | Douglas de Sousa Soares Malena Gadelha Cavalcante Samille Maria Vasconcelos Ribeiro Rayana Café Leitão Ana Patrícia Freitas Vieira Roberto da Justa Pires Neto Geraldo Bezerra da Silva Junior Elizabeth de Francesco Daher |
| author_facet | Douglas de Sousa Soares Malena Gadelha Cavalcante Samille Maria Vasconcelos Ribeiro Rayana Café Leitão Ana Patrícia Freitas Vieira Roberto da Justa Pires Neto Geraldo Bezerra da Silva Junior Elizabeth de Francesco Daher |
| author_sort | Douglas de Sousa Soares |
| collection | DOAJ |
| description | Objective: To assess clinical and laboratory data, and acute kidney injury (AKI) in HIV-infected children using and not using highly active antiretroviral therapy (HAART) prior to admission. Methods: A retrospective study was conducted with HIV-infected pediatric patients (<16 years). Children who were using and not using HAART prior to admission were compared. Results: Sixty-three patients were included. Mean age was 5.3 ± 4.27 years; 55.6% were females. AKI was observed in 33 (52.3%) children. Patients on HAART presented lower levels of potassium (3.9 ± 0.8 vs. 4.5 ± 0.7 mEq/L, p = 0.019) and bicarbonate (19.1 ± 4.9 vs. 23.5 ± 2.2 mEq/L, p = 0.013) and had a higher estimated glomerular filtration rate (102.2 ± 36.7 vs. 77.0 ± 32.8 mL/min/1.73 m2, p = 0.011) than those not on HAART. In the multivariate analysis, the use of HAART prior to the admission was a protective factor for AKI (p = 0.036; OR = 0.30; 95% CI = 0.097–0.926). Conclusion: AKI is a common complication of pediatric HIV infection. Use of HAART prior to the admission preserved glomerular filtration and was a protective factor for AKI, but increased medication side effects, such as hypokalemia and renal metabolic acidosis. Resumo: Objetivo: Avaliar dados clínicos e laboratoriais, bem como ocorrência de lesão renal aguda (LRA) em crianças HIV positivas com e sem uso de terapia antirretroviral altamente ativa (TARV) antes da admissão. Método: Foi realizado estudo retrospectivo em pacientes pediátricos HIV positivos (<16 anos). Foram comparadas as crianças que estavam em uso com aquelas sem uso de TARV prévia à internação. Resultados: Foram incluídos 63 pacientes, com média de idade de 5,3 ± 4,27 anos, sendo 55,6% do sexo feminino. LRA foi encontrada em 33 casos (52,3%). Os pacientes usando TARV apresentaram menores níveis de potássio (3,9 ± 0,8 vs. 4,5 ± 0,7 mEq/L, p = 0,019) e bicarbonato (19,1 ± 4,9 vs. 23,5 ± 2,2 mEq/L, p = 0,013), bem como maior taxa de filtração glomerular estimada (102,2 ± 36,7 vs. 77,0 ± 32,8 mL/min/1,73m2, p = 0,011) que o pacientes sem TARV prévia. Na análise multivariada o uso de TARV prévia à internação foi fator protetor contra LRA (p = 0,036; RC = 0,30; IC de 95% = 0,097-0,926). Conclusão: A LRA é uma complicação comum da infecção pediátrica pelo HIV. O uso de TARV antes da internação foi associado a melhor taxa de filtração glomerular e foi fator de proteção contra LRA, porém desencadeou efeitos colaterais como hipocalemia e acidose metabólica. Keywords: Acute kidney injury, HIV, Children, HAART, Palavras-chave: Insuficiência renal aguda, HIV, Crianças, TARV |
| first_indexed | 2024-04-11T12:27:57Z |
| format | Article |
| id | doaj.art-63c5dab2d9934ce096c19b0ca1b3b5df |
| institution | Directory Open Access Journal |
| issn | 0021-7557 |
| language | English |
| last_indexed | 2024-04-11T12:27:57Z |
| publishDate | 2016-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Jornal de Pediatria |
| spelling | doaj.art-63c5dab2d9934ce096c19b0ca1b3b5df2022-12-22T04:23:52ZengElsevierJornal de Pediatria0021-75572016-11-01926631637Acute kidney injury in HIV-infected children: comparison of patients according to the use of highly active antiretroviral therapyDouglas de Sousa Soares0Malena Gadelha Cavalcante1Samille Maria Vasconcelos Ribeiro2Rayana Café Leitão3Ana Patrícia Freitas Vieira4Roberto da Justa Pires Neto5Geraldo Bezerra da Silva Junior6Elizabeth de Francesco Daher7Universidade Federal do Ceará (UFC), Faculdade de Medicina, Departamento de Medicina Interna, Fortaleza, CE, BrazilUniversidade Federal do Ceará (UFC), Faculdade de Medicina, Departamento de Medicina Interna, Fortaleza, CE, BrazilUniversidade Federal do Ceará (UFC), Faculdade de Medicina, Departamento de Medicina Interna, Fortaleza, CE, BrazilUniversidade Federal do Ceará (UFC), Faculdade de Medicina, Departamento de Medicina Interna, Fortaleza, CE, BrazilUniversidade Federal do Ceará (UFC), Faculdade de Medicina, Departamento de Medicina Interna, Fortaleza, CE, BrazilUniversidade Federal do Ceará (UFC), Faculdade de Medicina, Departamento de Medicina Interna, Fortaleza, CE, BrazilUniversidade de Fortaleza (UNIFOR), Faculdade de Medicina, Centro de Ciências da Saúde, Fortaleza, CE, BrazilUniversidade Federal do Ceará (UFC), Faculdade de Medicina, Departamento de Medicina Interna, Fortaleza, CE, Brazil; Corresponding author.Objective: To assess clinical and laboratory data, and acute kidney injury (AKI) in HIV-infected children using and not using highly active antiretroviral therapy (HAART) prior to admission. Methods: A retrospective study was conducted with HIV-infected pediatric patients (<16 years). Children who were using and not using HAART prior to admission were compared. Results: Sixty-three patients were included. Mean age was 5.3 ± 4.27 years; 55.6% were females. AKI was observed in 33 (52.3%) children. Patients on HAART presented lower levels of potassium (3.9 ± 0.8 vs. 4.5 ± 0.7 mEq/L, p = 0.019) and bicarbonate (19.1 ± 4.9 vs. 23.5 ± 2.2 mEq/L, p = 0.013) and had a higher estimated glomerular filtration rate (102.2 ± 36.7 vs. 77.0 ± 32.8 mL/min/1.73 m2, p = 0.011) than those not on HAART. In the multivariate analysis, the use of HAART prior to the admission was a protective factor for AKI (p = 0.036; OR = 0.30; 95% CI = 0.097–0.926). Conclusion: AKI is a common complication of pediatric HIV infection. Use of HAART prior to the admission preserved glomerular filtration and was a protective factor for AKI, but increased medication side effects, such as hypokalemia and renal metabolic acidosis. Resumo: Objetivo: Avaliar dados clínicos e laboratoriais, bem como ocorrência de lesão renal aguda (LRA) em crianças HIV positivas com e sem uso de terapia antirretroviral altamente ativa (TARV) antes da admissão. Método: Foi realizado estudo retrospectivo em pacientes pediátricos HIV positivos (<16 anos). Foram comparadas as crianças que estavam em uso com aquelas sem uso de TARV prévia à internação. Resultados: Foram incluídos 63 pacientes, com média de idade de 5,3 ± 4,27 anos, sendo 55,6% do sexo feminino. LRA foi encontrada em 33 casos (52,3%). Os pacientes usando TARV apresentaram menores níveis de potássio (3,9 ± 0,8 vs. 4,5 ± 0,7 mEq/L, p = 0,019) e bicarbonato (19,1 ± 4,9 vs. 23,5 ± 2,2 mEq/L, p = 0,013), bem como maior taxa de filtração glomerular estimada (102,2 ± 36,7 vs. 77,0 ± 32,8 mL/min/1,73m2, p = 0,011) que o pacientes sem TARV prévia. Na análise multivariada o uso de TARV prévia à internação foi fator protetor contra LRA (p = 0,036; RC = 0,30; IC de 95% = 0,097-0,926). Conclusão: A LRA é uma complicação comum da infecção pediátrica pelo HIV. O uso de TARV antes da internação foi associado a melhor taxa de filtração glomerular e foi fator de proteção contra LRA, porém desencadeou efeitos colaterais como hipocalemia e acidose metabólica. Keywords: Acute kidney injury, HIV, Children, HAART, Palavras-chave: Insuficiência renal aguda, HIV, Crianças, TARVhttp://www.sciencedirect.com/science/article/pii/S0021755716301036 |
| spellingShingle | Douglas de Sousa Soares Malena Gadelha Cavalcante Samille Maria Vasconcelos Ribeiro Rayana Café Leitão Ana Patrícia Freitas Vieira Roberto da Justa Pires Neto Geraldo Bezerra da Silva Junior Elizabeth de Francesco Daher Acute kidney injury in HIV-infected children: comparison of patients according to the use of highly active antiretroviral therapy Jornal de Pediatria |
| title | Acute kidney injury in HIV-infected children: comparison of patients according to the use of highly active antiretroviral therapy |
| title_full | Acute kidney injury in HIV-infected children: comparison of patients according to the use of highly active antiretroviral therapy |
| title_fullStr | Acute kidney injury in HIV-infected children: comparison of patients according to the use of highly active antiretroviral therapy |
| title_full_unstemmed | Acute kidney injury in HIV-infected children: comparison of patients according to the use of highly active antiretroviral therapy |
| title_short | Acute kidney injury in HIV-infected children: comparison of patients according to the use of highly active antiretroviral therapy |
| title_sort | acute kidney injury in hiv infected children comparison of patients according to the use of highly active antiretroviral therapy |
| url | http://www.sciencedirect.com/science/article/pii/S0021755716301036 |
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