Resumen
Background: There is a paucity of data on the clinicopathologic pattern of kidney disease in Human Immunodeficiency Virus (HIV) seropositive children from sub-Saharan Africa and non from South West Nigeria.
Objective: To determine the clinical pattern and outcome of kidney disease among HIV positive children hospitalised at a tertiary hospital South West Nigeria
Methodology: A retrospective study of all HIV positive children who were hospitalised and managed for kidney diseases over a period of 78 months at the University College Hospital Ibadan, South West Nigeria. Patients were followed up over the duration of hospital admission.
Results: Ten children (six males and four females) aged 4 -15(10.4±3.2) years were identified. Four presented in acute kidney injury, (AKI) three with nephrotic syndrome (NS) and two in chronic kidney failure (CKF). One patient had left renal artery stenosis. Renal biopsy performed in three children showed focal segmental glomerulosclerosis in two patients and membranous nephropathy in the third. Management included antiretroviral therapy, Angiotensin Converting Enzyme Inhibitors and acute haemodialysis. Mortality was 40%.
Conclusion: AKI, NS and CKF were the predominant clinical patterns of kidney disease in hospitalised HIV positive children and the mortality is high.
Keywords: HIV, Children, Acute Kidney Injury, Chronic kidney Failure, Nephrotic Syndrome, Nigeria
Résumé
Contexte: Il ya un manque de données sur le modèle anatomo-clinique de la maladie rénale chez les enfants séropositifs en Afrique sub-saharienne ce qui n’est pas le cas au Sud-ouest du Nigeria.
Objectif: Déterminer le profil clinique et l’issue de la maladie rénale chez les enfants séropositifs hospitalisés dans les centres hospitaliers publics au Sud-ouest du Nigeria.
Méthodologie: Une étude rétrospective sur tous les enfants séropositifs qui ont été hospitalisés et qui suivaient des traitements relatifs aux maladies rénales pendant une période de 78 mois au Centre hospitalier universitaire d’Ibadan au Sud-ouest du Nigeria a été faite. Les patients ont été suivis pendant toute la durée d’hospitalisation.
Résultats: dix enfants (six garçons et quatre filles) dont l’âge varie entre 4 et 15 ans (10,4 ± 3,2) ont été identifiés. Parmi eux, il y avait quatre cas de lésions rénales aiguës, (LRA) trois cas de syndrome néphrotique (SN) et deux cas d’insuffisances rénales chroniques (IRC). Un patient a été guéri de la sténose artérielle rénale. La biopsie rénale effectuée sur trois enfants a montré une glomérulosclérose segmentaire et focale chez deux patients et une néphropathie membraneuse chez le troisième. Le traitement incluait la thérapie antirétrovirale, les inhibiteurs de l’ECA et l’hémodialyse aiguë. La mortalité était de 40%.
Conclusion: Les LRA, les SN et les IRC étaient les principaux modes cliniques de la maladie rénale chez les enfants séropositifs hospitalisés et la mortalité était élevée.
Correspondence: Dr. AD Ademola, Departent of Paediatrics, Faculty of Clinical Sciences, College of Medicine, U.I. Ibadan, Oyo State, Nigeria.e-mail: dr_deboademola@yahoo.co.uk
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