Acute kidney injury in HIV-infected children: comparison of patients according to the use of highly active antiretroviral therapy [Lesão renal aguda em crianças com HIV: estudo comparativo entre pacientes com e sem terapia antirretroviral altamente ativa]

Objective to assess clinical and laboratory data,and acute kidney injury (aki) in hiv-infected children using and not using highly active antiretroviral therapy (haart) prior to admission. methods a retrospective study was conducted with hiv-infected pediatric patients (<16 years). children who were using and not using haart prior to admission were compared. results sixty-three patients were included. mean age was 5.3 ± 4.27 years; 55.6% were females. aki was observed in 33 (52.3%) children. patients on haart presented lower levels of potassium (3.9 ± 0.8 vs. 4.5 ± 0.7 meq/l,p = 0.019) and bicarbonate (19.1 ± 4.9 vs. 23.5 ± 2.2 meq/l,p = 0.013) and had a higher estimated glomerular filtration rate (102.2 ± 36.7 vs. 77.0 ± 32.8 ml/min/1.73 m2,p = 0.011) than those not on haart. in the multivariate analysis,the use of haart prior to the admission was a protective factor for aki (p = 0.036; or = 0.30; 95% ci = 0.097–0.926). conclusion aki is a common complication of pediatric hiv infection. use of haart prior to the admission preserved glomerular filtration and was a protective factor for aki,but increased medication side effects,such as hypokalemia and renal metabolic acidosis. © 2016 sociedade brasileira de pediatria