Kidney function of HIV‐infected children in Lagos, Nigeria: using Filler's serum cystatin C‐based formula

• Published in: Journal of the International AIDS Society Vol. 13; no. 1; p. 17
• Main Authors: Esezobor, Christopher I, Iroha, Edna, Oladipo, Olajumoke, Onifade, Elizabeth, Soriyan, Oyetunji O, Akinsulie, Adebola O, Temiye, Edamisan O, Ezeaka, Chinyere
• Format: Journal Article
• Language: English
• Published: Switzerland The International AIDS Society 18.05.2010; John Wiley & Sons, Inc; BioMed Central Ltd; Wiley
• Subjects: AIDS/HIV; Case-Control Studies; Child; Child, Preschool; Children; Complications and side effects; Cystatin C - blood; Demographic aspects; Female; Glomerular Filtration Rate; Health aspects; HIV infection; HIV infection in children; HIV Infections - physiopathology; Human immunodeficiency virus; Humans; Infant; Kidney - physiopathology; Kidney diseases; Kidney Diseases - diagnosis; Kidney Diseases - physiopathology; Kidney Function Tests; Kidneys; Nigeria; Physiological aspects; Risk factors; Nigeria; United States; United Kingdom
• ISSN: 1758-2652; 1758-2652
• DOI: 10.1186/1758-2652-13-17

Background Limited data is available on kidney function in HIV‐infected children in sub‐Saharan Africa. In addition, malnutrition in these children further reduces the utility of diagnostic methods such as creatinine‐based estimates of glomerular filtration rate. We determined the serum cystatin C level and estimated glomerular filtration rate of 60 antiretroviral‐naïve, HIV‐infected children and 60 apparently healthy age and sex matched children. Methods Serum cystatin C level was measured using enzyme‐linked immunosorbent assay technique, while glomerular filtration rate was estimated using Filler's serum cystatin C formula. Student t test, Mann Whitney U test, Pearson chi square and Fisher's exact test were used, where appropriate, to test difference between groups. Results Compared to the controls, the HIV‐infected group had significantly higher median (interquartile range) serum cystatin C levels {0.77 (0.29) mg/l versus 0.66 (0.20) mg/l; p = 0.025} and a higher proportion of children with serum cystatin C level >1 mg/l {10 (16.7%) versus one (1.7%); p = 0.004}. The HIV‐infected children had a mean (± SD) eGFR of 96.8 (± 36.1) ml/min/1.73 m2 compared with 110.5 (± 27.8) ml/min/1.73 m2 in the controls (p = 0.021). After controlling for age, sex and body mass index, only the study group (HIV infected versus control) remained a significant predictor of serum cystatin C level (β = ‐0.216, p = 0.021). The proportion of HIV‐infected children with eGFR <60 ml/min/1.73 m2 was eight (13.3%) versus none (0%) in the control group (p = 0.006). However, the serum cystatin C level, eGFR and proportions of children with serum cystatin C level >1 mg/l and eGFR <60 ml/min/1.73 m2 were not significantly different between the HIV‐infected children with advanced disease and those with milder disease. Conclusions HIV‐infected children in Nigeria have higher serum cystatin C level and lower eGFR compared to age and sex matched controls.