Abstract

The aim of the study is to study the Renal changes and decline in eGFR with comparison to the different HAART regimens after the HAART initiation by using Cockcroft – Gault formula. The 100 newly diagnosed HIV positive patients were included in the study. Detailed history – including duration of disease, any past history of antiretroviral drug and other medications, treatment regimen started, WHO staging of the HIV disease were obtained . Result: In our study results shows that, before starting ART most patients, 54% were in eGFR between 60-90 category and 25% were in >90 category and at the end of study after HAART initiation, 79% of patients were in eGFR<90 ml/min. of which, 34% in <60 (moderate to severe) and 45% in 60-90 eGFR(mild reduction). Approximately 21% of patients with normal baseline eGFRfalls into severe decline in eGFR after ART introduction. The overall average mean eGFR at the end of study in this sample is 68.29±27.54. Also renomegaly / contraceted kidney was found in 15 patients (15%) and 85 patients (85%) had normal sized kidneys. Conclusion: In our study 49% had albuminuria. Among them, 24 % have significant albuminuria (2+, 3+) and all patients had significant decline in eGFR of < 60 .There is a significant P value between Urine albumin and eGFR. This highlights the critical and underappreciated need to monitor renal function in HIV positive patients attending ART clinic at GRMC, particularly in this era where Tenofovir is being used in first line ART regimen in majority of patients as recommended by WHO.

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