Evidence-based Medicine: Time for a change? - Journal of Medical ...

ORIGINAL ARTICLE
Results: The two years prospective study
included 3545 HIV-seropositive patients who
were referred to the ART centre for further
evaluation. Of 3545 HIV-seropositive patients,
1725 (1114 males, 611 females) patients were
enrolled or ART drugs as they fulfilled the
NACO guidelines of India for the treatment of
AIDS. The clinical renal disease was noted in
47/3545 (1.33%) patients. The majority of HIVseropositive
patients with clinical renal
disease were males (93.61%) (Table 1).
Maximum number of patients were in the age
LEGENDS
Table 1 : Demography of patients (n=47).
Parameter Number %
Sex Male
Female 44 93.61
3 6.38
Age 15-20 2 4.25
21-30 12 25.53
31-40 23 48.93
41-50 8 17.02
>50 2 4.25
Table 5 : 24 hours Urinary Protein, CD4 count
and Mortality (n=47).
Table 6 :Serum creatinine, CD4 count and
Mortality (n=47).
Table 2 : Spectrum of clinical renal disease in
HIV-serpositive patients (n=47).
Parameter Number %
AKI
Pre-renal 15 31.91
ATN 27 57.45
AIN 3 6.38
CKD stage IV 2 4.26
Proteinuria > 0.5 gm/day 32 68.06
Nephrotic syndrome 2 4.25
Table 3 : Causes of AKI (45/47).
Cause Number %
Hypovolemia 2 4.44
Sepsis 4 8.89
Urosepsis 3 6.67
Drug induced 3 6.67
*Mixed causes 33 82.23
*Dehydration, drug induced, bleeding, etc.
Table 4 : Outcome of AKI (n=45).
Cause
No. of patient (s) Percentage Status
AKI of various causes 36 80 Alive
Sepsis 4 8.89 Expired
Tubercular meningitis 3 6.67 Expired
Hypovolemia 2 4.44 Expired
group of 31 to 40 years (48.9%) and the age
of patients ranged between 16 and 58
(36.34±9.33) years. 28/47(59.57%) were
sexually active males having the occupation
of driver. 44 patients were married and 3 were
unmarried. Most of the patients were addicted
to alcohol (31), smoking (29) and ganja/
bhang (16).
Anemia (100%), weight loss (100%), oral
candidiasis (61.70%), fever (68.08%),
respiratory problems mostly due to pulmonary
tuberculosis (23.79%) and decreased Urine
output (27.65%) were the common
manifestations in HIV-seropositive patients
with clinical renal disease (Table not shown).
Acute kidney injury (AKI) was the most
common renal manifestation of HIVseropositive
patients. Acute tubular necrosis
(57.45%) was the prominent intrinsic renal
lesion of AKI in these patients (Table 2). AKI in
HIV-serpositive patients had mixed causes
(82.23%) like dehydration, drugs, and bleeding.
Sepsis (15.56%) was the common factor
10 JMS * JMS Vol 25 * Vol * No. 25 3 * No. * September, 1 * June, 2010 2011