Persistent proteinuria as an indicator of renal disease in HIV-infected children

Main Article Content

Yuni Hisbiiyah
Risky Vitria Prasetyo
Dwiyanti Puspitasari
Ninik Asmaningsih Soemyarso
Ismoedijanto Moedjito
Mohammad Sjaifullah Noer

Abstract

Background Persistent proteinuria (microalbuminuria) has been reported to be a precursor of HIV-related renal disease. Screening allows for early management in order to prevent the progression of renal disease and decrease morbidity and mortality associated with chronic kidney disease in HIV. Several studies have been done on renal manifestation in HIV-infected children from American and African regions, but similar studies from Asia are lacking.

Objective To determine the prevalence of persistent proteinuria in HIV-positive children on antiretroviral therapy (ARV) in Dr. Soetomo Hospital, Surabaya.

Methods A cross-sectional study on children with HIV and treated with  highly active antiretroviral therapy (HARRT) was done from August 2014 to February 2015. Microalbuminuria was measured by the ratio of urine albumin to creatinine (ACR), while proteinuria was measured by dipstick. Measurements were performed 3 times in 4-8 weeks. All subjects underwent complete evaluation of blood tests, serum creatinine, blood urea nitrogen (BUN), CD4 counts, and urinalysis. Data were analyzed using Chi-square and logistic regression tests.

Results Of 38 children on HARRT enrolled in this study, 2 subjects developed acute kidney injury (AKI), 4 subjects were suspected to have urinary tract infection (UTI), and 1 subject was suspected to have urinary tract stones. The prevalence of persistent microalbuminuria was 2.6%. There was no correlation between immunological status, WHO clinical stage, or duration of ARV and the incidence of persistent proteinuria (P>0.05).

Conclusion The prevalence of persistent proteinuria is  lower in younger HIV-infected children at a non-advanced stage and HIV-infected children with normal immunological status who are on HAART. We provide baseline data on the renal conditions of HIV-infected children in the era of HAART, before tenovofir is  increasingly used as an antiretroviral therapy regimen in Indonesia.

Article Details

How to Cite
1.
Hisbiiyah Y, Prasetyo R, Puspitasari D, Soemyarso N, Moedjito I, Noer M. Persistent proteinuria as an indicator of renal disease in HIV-infected children. PI [Internet]. 16Jan.2017 [cited 21Jul.2019];56(6):343-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/168
Section
Pediatric Nephrology
Author Biographies

Yuni Hisbiiyah, Department of Child Health, Airlangga University Medical School/Dr. Soetomo Hospital Surabaya, East Java

Department of Child Health, Airlangga University Medical School/Dr. Soetomo Hospital
Surabaya, East Java

Risky Vitria Prasetyo, Department of Child Health, Airlangga University Medical School/Dr. Soetomo Hospital Surabaya, East Java

Consultant Pediatric Nephrologist

Division of Nephrology

Department of Child Health, Airlangga University Medical School/Dr. Soetomo Hospital
Surabaya, East Java

Dwiyanti Puspitasari, Department of Child Health, Airlangga University Medical School/Dr. Soetomo Hospital Surabaya, East Java

Consultant
Division of Tropical Disease and Infection

Department of Child Health, Airlangga University Medical School/Dr. Soetomo Hospital 

Surabaya, East Java

Ninik Asmaningsih Soemyarso, Department of Child Health, Airlangga University Medical School/Dr. Soetomo Hospital Surabaya, East Java

Consultant
Division of Nephrology
Department of Child Health
Medical Faculty of Airlangga University
Dr Soetomo Hospital
Surabaya, Indonesia

Ismoedijanto Moedjito, Department of Child Health, Airlangga University Medical School/Dr. Soetomo Hospital Surabaya, East Java

Consultant
Division of Tropical Disease and Infection

Department of Child Health, Airlangga University Medical School/Dr. Soetomo Hospital
Surabaya, East Java

Mohammad Sjaifullah Noer, Department of Child Health, Airlangga University Medical School/Dr. Soetomo Hospital Surabaya, East Java

Consultant
Division of Nephrology

Department of Child Health, Airlangga University Medical School/Dr. Soetomo Hospital
Surabaya, East Java

Received 2016-08-15
Accepted 2016-12-20
Published 2017-01-16

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