Acute kidney injury in HIV-infected children: comparison of patients according to the use of highly active antiretroviral therapy

作者：Soares Douglas de Sousa; Cavalcante Malena Gadelha; Vasconcelos Ribeiro Samille Maria; Leitao Rayana Cafe; Freitas Vieira Ana Patricia; Pires Neto Roberto da Justa; da Silva Junior Geraldo Bezerra; Daher Elizabeth de Francesco^*

来源：Jornal de Pediatria, 2016, 92(6): 631-637.

DOI：10.1016/j.jped.2016.03.009

• Acute kidney injury
• HIV
• Children
• HAART

Objective: To assess clinical and laboratory data, and acute kidney injury (AKI) in HIV-infected children using and not using highly active antiretroviral therapy (HAART) prior to admission.
Methods: A retrospective study was conducted with HIV-infected pediatric patients (<16 years). Children who were using and not using HAART prior to admission were compared.
Results: Sixty-three patients were included. Mean age was 5.3 +/- 14.27 years; 55.6% were females. AKI was observed in 33 (52.3%) children. Patients on HAART presented lower levels of potassium (3.9 +/- 0.8 vs. 4.5 +/- 0.7 mEq/L, p = 0.019) and bicarbonate (19.1 +/- 4.9 vs. 23.5 +/- 1 2.2 mEq/L, p = 0.013) and had a higher estimated glomerular filtration rate (102.2 +/- 1 36.7 vs. 77.0 +/- 132.8 mL/min/1.73 m(2), p = 0.011) than those not on HAART. In the multivariate analysis, the use of HAART prior to the admission was a protective factor for AKI (p = 0.036; OR = 0.30; 95% 0 = 0.097-0.926).
Conclusion: AKI is a common complication of pediatric HIV infection. Use of HAART prior to the admission preserved glomerular filtration and was a protective factor for AKI, but increased medication side effects, such as hypokalemia and renal metabolic acidosis.

• 出版日期2016-12