To Assess the Impact of Antiretroviral Therapy on Renal Function in Hiv-Infected Patients
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Abstract
Although antiretroviral therapy (ART) has revolutionized the treatment of HIV infection, it can be harmful to renal function, especially when used with some nephrotoxic drugs. HIV-infected patients frequently have chronic kidney disease (CKD), which makes continuous renal health monitoring necessary. With emphasis on the effects of frequently administered antiretroviral medications, this study attempts to evaluate the effect of ART on renal function in people with HIV.
Material & Methods: Prospective cohort study was conducted at Shri Mahant Indiresh Hospital's Outpatient Department in Uttarakhand with 40 HIV-infected patients receiving ART. Patients aged 18 and older who agreed to participate were eligible, while those with contraindications to ART were excluded. Renal function parameters such as serum creatinine, estimated glomerular filtration rate (eGFR), proteinuria, and serum urea were measured monthly. To analyze changes in renal biomarkers, statistical analyses were performed using R Studio, applying the Wilcoxon signed-rank test and the paired t-test.
Results: The study identified significant changes in renal biomarkers after ART initiation. The number of patients with elevated serum creatinine levels (≥1.6 mg/dL) increased from one to five. The eGFR levels showed a concerning trend, with more patients falling into lower eGFR categories after treatment. Proteinuria levels rose from 19 patients (<150 mg/day) to 26 patients (number_1 mg/day). Serum urea levels also increased notably, suggesting possible renal impairment caused by ART.
Conclusion: The findings highlight the nephrotoxic potential of certain antiretroviral drugs, especially Tenofovir disoproxil fumarate, emphasizing the importance of regular renal function monitoring in HIV-infected patients on ART. Early detection of renal impairment is essential for prompt intervention, and healthcare providers should explore alternative ART options for patients showing signs of renal failure. Further research is needed to develop effective strategies to reduce renal toxicity and improve long-term kidney health in this population.