Renal insufficiency in Ghanaian HIV infected patients: need for dose adjustment|
Owiredu, WKBA; Quaye, L; Amidu, N & Addai-Mensah, O
Background: Antiretrovirals (ARVs) could lead to clinically significant nephrotoxicity and as such will require dose adjustments
in the presence of renal insufficiency.
Objective: To explore renal function estimating equations as alternatives for glomerular filtration rate (GFR) measurement
in a stable cohort of HIV-infected patients.
Methods:In estimating renal insufficiency in Ghanaian HIV-infected patients, GFR for 276 HAART-naïve patients and 166
patients on HAART was estimated with the Cockcroft-Gault, 4v-MDRD and CKD-EPI estimating equations.
Results:Females outnumbered males by 3 to 1 in the HAART-naïve group and 4 to 1 in subjects on HAART. The
prevalence of renal insufficiency calculated with the Cockcroft-Gault, 4v-MDRD and CKD-EPI equations was 8.7%, 9.1%
and 8.7% in HAART-naïve patients; 14.5%, 12.6% and 12.6% in patients on HAART; 7.7%, 11.5% and 11.5% in HAARTnaïve
males; 10.8%, 8.1% and 8.1% in males on HAART; 9.1%, 8.0% and 7.5% in HAART-naïve females and 15.5%, 14.0%
and 14.0% in females on HAART. The CKD-EPI equation yielded lower bias when compared to the Cockcroft-Gault and
Conclusion:Renal insufficiency is not uncommon among HIV infected Ghanaian patients. A significant proportion (10 to
11%) will require ARV dose adjustment at the time of initiating therapy or sometime during on-going therapy.
Antiretroviral, predictive equation, renal function, HIV, Ghana