Serum electrolytes and renal alterations in HIV-seropositive Mexican subjects

• Published in: Medicine (Baltimore) Vol. 100; no. 20; p. e26016
• Main Authors: Garza Tovar, Oscar Antonio, Pérez, Alberto Alejandro Miranda, Pérez, María Elena Gutiérrez, Robledo, Ivonne Urraza, Galarza, Faviel F. González, Márquez, Francisco Carlos López
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 21.05.2021
• Subjects: Adult; Aged; Anti-Retroviral Agents - therapeutic use; Electrolytes - blood; Female; Glomerular Filtration Rate - physiology; HIV Seropositivity - blood; HIV Seropositivity - complications; HIV Seropositivity - drug therapy; Humans; Male; Mexico; Middle Aged; Observational Study; Prevalence; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - epidemiology; Risk Factors; Young Adult; Mexico
• DOI: 10.1097/MD.0000000000026016
• ISSN: 0025-7974; 1536-5964

To examine potential risk factors associated with biochemical alterations in renal function in a population diagnosed with HIV/AIDS undergoing antiretroviral treatment.This is an observational, transversal, and relational design study that included 179 HIV-seropositive subjects. Glucose serum, cholesterol, triglycerides, total proteins, albumin, creatine, urea, blood urea nitrogen (BUN), and electrolytes levels were determined for each individual. Renal function was evaluated through the glomerular filtration rate (GFR), using the CKD-EPI equation. Chronic kidney disease (CKD) was defined as estimated glomerular filtration rate  < 60 mL/min/1.73 m2. Univariate model significant variables, with a 95% confidence interval (CI), were included in a multivariate logistic regression analysis.CKD prevalence in patients was 7.3%, with comorbidities of 7.8% for type 2 diabetes mellitus, 7.3% for arterial hypertension, and 35.2% for dyslipidemia. Additionally, both hypernatremia and hypophosphatemia were detected in 57% (n = 102) of the patients. Multivariate logistic regression suggested that CD4+ T cell count < 200 (P = .02; OR 0.2; CI 95% 0.08-0.8) was associated to hyponatremia; similarly, detectable viral load was associated to hypokalemia (P = .02; OR 5.1; CI 95% 1.2-21.3), hypocalcemia (P = .01; OR 4.1; CI 95% 1.3-12.3), and hypermagnesemia (OR 3.9; CI 95% 1.1-13.6). Patient age was associated to both hypophosphatemia (P = .01; OR 2.4; CI 95% 1.1-5.0) and hypermagnesemia (P = .01; OR 2.8; IC 95% 1.1-7.0), and high creatinine levels were associated to nucleoside reverse transcriptase inhibitor treatment (P = .001; OR 42.5; CI 95% 2.2-806.9). Lastly, high BUN levels were associated to age (P = .03; OR 3.8; CI 95% 1.0-14.4), while GFR 60 to 89 mL/min/1.73 m2 was associated to dyslipidemia (P = .02; OR 2.2; CI 95% 1.1-4.5).CD4+ T cell and viral load were the main factors associated with renal biochemical alterations.