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Monday, 20 June 2016 08:57

Clinical Research: Can urine β2-microglobulin excretion be used as a screening test for detection of renal tubular dysfunction in HIV infected children less than five years old?

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image sigwadiName: Patience Sigwadi

Hospital / Affiliation: Steve Biko Academic Hospital

Home Country: South Africa

Host Country: South Africa

Year: 2012

Status of your program: COMPLETED

 

 

Title of the project: 

Can urine β2-microglobulin excretion be used as a screening test for detection of renal tubular dysfunction
in HIV infected children less than five years old?

Topic: 

Pediatric Nephrology 

Short description of the project or abstract:

Aim:

  • To compare the urine β2-microglobulin:creatinine ratio (u-β2M:Creat) of HIV infected children age 6 week to 5 year old with those of healthy children in the same age range
  • To determine if u- β2M: creatinine ratio can be used as a screening tool for early detection of renal tubular dysfunction

Method:
This is a cross-sectional observational study evaluating u-β2M: creatinine ratio of HIV infected and healthy children age 6 weeks to 5 years. The study group included HIV infected children attending 3 different immunology clinics in Pretoria, South Africa. The control group was healthy HIV negative children of the same age groups attending a single immunization clinic. Exclusion criteria for study patients were: babies born incomplete

Results:
A total of 95 participants were enrolled, 57/95 were study patients (Group A) and 38/95 control (Group B). Groups A and B consisted of 33 and 23 participants ≤24 months old and 24 and 15 participants >24 months old respectively. Proteinuria was detected in 7/57 (12.3%) HIV infected and 3/38 (7.9%) healthy infants. Mean (±SD) u-β2M: Creat ratios were 0.220 ± 0.551 and 0.276 ±0.948 in children ≤ 24 months and 0.082 ± 0.192 and 0.018 ± 0.008 in children >24 months old in Groups A and B respectively. (P= 0.12). U-β2M:Creat ratio were elevated >0.052 mg/mmol in 27/57 (47.4%) and 4/38 (10.5%) children in groups A and B respectively. Mean (±SD) U-β2M: Creat ratios were 0.174 (±0.742) in Group B. Serum HCO3 levels (Normal 21-29 mmol/L) were decreased in the study group 17.1 ± 3.5 and 17.5 ± 2.6 in children ≤24 months and >24 months respectively. S-HCO3 levels were 18(±2.3) and 17(±3.5) mmol/L in Bactrim and no Bactrim treated groups respectively refuting the notion that Bactrim is the cause of acidosis in this population. It was not possible to analyze the effect of different antiretroviral drugs on urine beta2 microglobulin excretion as there were too many drug combinations.

 

Conclusion:

Higher levels of urine β2-microglobulin excretion were observed in healthy children and in HIV infected children. HIV infected children >2 years had higher U-β2M:Creat ratio compared to healthy children of the same age. HIV children had significantly low HCO3 levels compared to the normal reference laboratory level.
In conclusion this study does not support the use of U-β2M: Creat ratios to screen for renal tubular disease in HIV infected children less than 5 years old.

 

Additional Info

  • Year: 2012
  • Status: Completed
  • Region: Africa
  • Country: South Africa
  • Topics: Paediatric nephrology
Read 5914 times Last modified on Monday, 27 June 2016 07:50

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