Renal Disease among HIV Positive Patients in Senegal

作     者：Khodia Fall Mouhamadou Moustapha Cissé Ahmed Tall Lemrabott Maria Faye Mouhamed Cherif Dial Atoumane Faye Seynabou Fall Moustapha Faye Alex Keita Mansour Mbengue Seynabou Diagne Niakhaleen Keita Bacary Ba Abdou Niang Boucar Diouf El Hadji Fary Ka 

作者机构：Nephrology and Hemodialysis Department CHU Aristide Le Dantec Dakar Senegal Cytology and Histopathology Department Grand-Yoff General Hospital Dakar Senegal Internal Medicine Department CHU Aristide Le Dantec Dakar Sénégal 

出 版 物：《Open Journal of Nephrology》 (肾脏病（英文）)

年 卷 期：2017年第7卷第4期

页      面：101-106页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Kidney Disease HIV HIVAN Senegal 

摘      要：Introduction: Renal disease (RD) in human immunodeficiency virus (HIV) infection is a decisive turning point in the development and prognosis of this disease. In Africa, the prevalence varies between 2.5% and 48.6%. In Senegal, little data are available in the literature. The objective of our study was to describe the epidemiological, clinical, paraclinical, therapeutic and progressional aspects in patients living with HIV (PLWHIV). Patients and methods: This was a retrospective, descriptive and analytical study carried out over a 10-year period in the Department of Internal Medicine and Nephrology at the Aristide Le Dantec Hospital in Dakar, Senegal. We included all 15-year old and above PLHIV with available CD4 count and viral load. Results: Out of 248 PLHIV, 32 had kidney disease (KD), which means a hospital prevalence of 12.9%. The mean age was 51.22 ± 10 years (extremes of 36 and 77 years) with a sex ratio (male/female) of 1.28. Renal signs were dominated by glomerular nephropathy syndrome. It was present at 80%. Tubulo-interstitial nephropathy syndrome and chronic uremic syndrome accounted for 6.25% and 3.1% of cases, respectively. Renal function Impairment was present in 21 patients with 18 cases of acute kidney injury (85.7%) and 3 cases of chronic renal failure (14.3%), including 2 in stage 5 of chronic kidney disease. Renal biopsy (RB) was indicated and performed in 20 (62.5%) patients with glomerular signs in 12 patients (60%). Glomerular lesions were dominated by focal and segmental glomerulosclerosis (FSGS) in 6 cases, membraneous nephropathy (MN) in 4 cases and minimal change disease (MCD) in 2 cases. Tubulo-interstitial and vascular lesions were present in 45% and 12.5% of cases, respectively. In highly active antiretroviral therapy (HAART), 12 (37.5%) patients had total remission, 9 (28.12%) had partial remission. One (3.12%) death from severe metabolic acidosis on chronic renal failure was deplored. Conclusion: This study illustrates the high preval