Acute kidney injury in hospitalized HIV-infected patients living in Cote d’Ivoire

Introduction: Infection with human immunodeficiency virus (HIV) is a common cause of renal dysfunction.Objectives: We aimed to describe the epidemiological and etiological profile of acute kidney injury (AKI) in HIV infected patients.Patients and Methods: This is a descriptive cohort study which was carried out during the period of January ۲۰۰۹ to December ۲۰۱۴ in department of nephrology-internal medicine of university hospital of Treichville. The highest value of serum creatinine (sCr) was used to stage AKI using the Acute Kidney Injury Network (AKIN) with different stages of AKI. Cox regression analysis was used to identify independent predictors of mortality.Results: Our study included ۱۴۶ patients whose mean age was ۴۲±۱۰ years with a female predominance (sex ratio ۰.۵۶). The positive retroviral status was unknown at admission in most cases (۶۳%). The average CD۴ cell count was ۱۲۵±۸ cells/mm۳. The causes were dominated by infections (۶۷.۸%) and water loss (۲۴%). The outcome was favorable in ۶۷% of cases. Factors such as clinical AIDS stage (odds ratio [OR] = ۲.۹۴; ۹۵% CI = ۱.۴۷-۵.۹۰; P = ۰.۰۰۲), coma (OR = ۹.۶۵; ۹۵% CI = ۷.۲۹-۱۱.۸۸; P = ۰.۰۰۱), severity of immunosuppression (P = ۰.۰۲), septic shock (OR = ۳.۷۰; ۹۵% CI = ۱.۶۱-۸.۴۹; P = ۰.۰۰۲) and acute pyelonephritis (OR = ۹.۶۱; ۹۵% CI = ۲.۴۵-۳۷.۶۵; P = ۰.۰۰۱) were associated with mortality in our patients.Conclusion: AKI occurs at a late stage of HIV/AIDS infection and is in most cases the circumstance of discovery of retroviral infection. The causes are dominated by infections and digestive disorders responsible for water loss.

Keywords:

Acute kidney injury , HIV infection , Water loss , Digestive mycosis , Cervical cancer , Human immunodeficiency virus (HIV)