Sundaramoorthy S, Radha D, Ravi A, Reddy KS, Varatharajan S. Structural and functional kidney abnormalities in patients with Human immunodeficiency virus infection: A cross-sectional perspective. World J Nephrol 2025; 14(3): 107093 [DOI: 10.5527/wjn.v14.i3.107093]
Corresponding Author of This Article
Sakthivadivel Varatharajan, Additional Professor, Department of General Medicine, All India Institute of Medical Sciences-Bibinagar, Bibinagar, Hyderabad 500088, Telangana, India. vsakthivadivel28@gmail.com
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Sivaprakash Sundaramoorthy, Department of General Medicine, Government Tiruvannamalai Medical College and Hospital, Tiruvannamalai 606604, Tamilnadu, India
Devarajan Radha, Department of General Medicine, Government Villupuram Medical College, Mundiyampakkam, Villupuram 605601, Tamilnadu, India
Amalraj Ravi, Department of General Medicine, Tirunelveli Medical College, Tirunelveli 627011, Tamilnadu, India
Kotha Sugunakar Reddy, Department of General Medicine, Neelima Institute of Medical Sciences, Hyderabad 500088, Telangana, India
Sakthivadivel Varatharajan, Department of General Medicine, All India Institute of Medical Sciences-Bibinagar, Hyderabad 500088, Telangana, India
Author contributions: Sundaramoorthy S conceived and designed; Ravi A and Radha D participated in coordination of the study and drafted the initial manuscript; Sundaramoorthy S, Ravi A, and Radha D participated in the acquisition; Sundaramoorthy S, Ravi A, Radha D, Varatharajan S, and Reddy KS participated in the interpretation of data; Varatharajan S and Reddy KS participated in the analysis, drafting the final manuscript and revised the article critically for important intellectual content; and all authors have read and approved the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Government Villupuram Medical College, approval No. GVMC/IEC/2021/16.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at vsakthivadivel28@gmail.com.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sakthivadivel Varatharajan, Additional Professor, Department of General Medicine, All India Institute of Medical Sciences-Bibinagar, Bibinagar, Hyderabad 500088, Telangana, India. vsakthivadivel28@gmail.com
Received: March 16, 2025 Revised: April 11, 2025 Accepted: May 18, 2025 Published online: September 25, 2025 Processing time: 186 Days and 18.8 Hours
Abstract
BACKGROUND
Chronic kidney disease is a progressive disease that evolves towards the development of end-stage renal disease. The superimposition of renal impairment on a complex disease, namely human immunodeficiency virus (HIV) infection, will raise the burden of comorbidities and, predict worse outcomes in this group of the population.
AIM
To evaluate the structural and functional defects of kidney in patients with HIV infection.
METHODS
This cross-sectional study involved 227 patients with HIV infection. Participants were selected by simple random sampling method. Eligible participants included HIV infection-positive adults aged 18 years and above. Exclusion criteria encompassed individuals with preexisting hypertension, diabetes mellitus, chronic kidney disease, chronic liver disease, and those receiving nephrotoxic drugs. Informed consent was obtained. Data collection involved recording medical histories, conducting clinical examinations, and performing baseline blood investigations and ultrasonography to assess renal function and structural abnormalities.
RESULTS
The mean age of participants was 41 years. Females constituted 66.5%; 78% were on Tenofovir-based regimen. The mean duration of HIV infection was 5 years; mean duration of antiretroviral therapy was 4 years. 67.4% had a body mass index over 25. World Health Organization staging of HIV infection revealed that 41.9% were in stage 3, 30% in stage 2. 35.7% had cluster differentiation 4 counts < 200. The mean creatinine was 1 mg/dL and mean urea was 25.1 mg/dL. 54.6% had estimated glomerular filtration rate of < 60. Enlarged kidneys in 39.2% and increased echogenicity in 82.8% of participants. A decline in estimated glomerular filtration rate and an increase in kidney size was significantly associated with advancing HIV stages.
CONCLUSION
Both structural and functional kidney abnormalities are common in patients with HIV infection. These abnormalities increase with disease progression, underscoring the need for regular and consistent renal monitoring.
Core Tip: Renal abnormalities are commonly observed in individuals with human immunodeficiency virus (HIV) infection, particularly as the disease progresses. Advanced stages of HIV are associated with a significant decline in estimated glomerular filtration rate and an increase in kidney size, indicating worsening renal function. Consequently, routine monitoring of kidney health, including estimated glomerular filtration rate and imaging when appropriate, is essential for early detection and management of HIV-related kidney complications.
