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LETTER TO EDITOR
Year : 2012  |  Volume : 53  |  Issue : 1  |  Page : 51  

Dipstick urinalysis should be documented prior to initiating antiretroviral therapy


Department of Genitourinary and HIV Medicine, Niger Delta University, College of Health Sciences, Wilberforce Island, Amassoma, Yenagoa, Bayelsa State, Nigeria

Date of Web Publication18-Aug-2012

Correspondence Address:
Tubonye C Harry
Niger Delta University, College of Health Sciences, Wilberforce Island, Amassoma, Yenagoa, Bayelsa State
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0300-1652.99834

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How to cite this article:
Harry TC. Dipstick urinalysis should be documented prior to initiating antiretroviral therapy. Niger Med J 2012;53:51

How to cite this URL:
Harry TC. Dipstick urinalysis should be documented prior to initiating antiretroviral therapy. Niger Med J [serial online] 2012 [cited 2021 May 15];53:51. Available from: https://www.nigeriamedj.com/text.asp?2012/53/1/51/99834

Sir,

I read the excellent article by Agbaji et al. [1] showing the predictors of renal dysfunction in HIV-positive patients initiating therapy with interest. The study highlighted the need of awareness of HIV-associated nephropathy (HIVAN) more common among blacks as a causal factor. Of importance is coinfection with either or both of hepatitis B and C, [2] increasingly recognized as causal of nephropathy and should therefore be screened at baseline among sub-Saharan African cohort.

A cheap but often neglected baseline investigation before initiating antiretroviral therapy is dipstick urinalysis for evaluation of proteinuria, recommended by most guidelines. [3] In a recent audit of case-notes in my former department in the United Kingdom [4] against the British HIV Association (BHIVA) guidelines, this was an area of concern, as less than 33% of our patients had documented dipstick urinalysis in the case-notes before commencement of therapy.

The article by Agbaji et al. [1] should now focus attention to this problem particularly with the availability of generic Tenofovir; known to be associated with reversible renal dysfunction as shown by Agbaji and others [5],[6] in sub-Saharan African cohorts. We will advocate documentation of routine urinalysis among other investigations prior to commencement of antiretroviral therapy and when Tenofovir is used 3-monthly serum creatinine with estimation of GFR. Dipstick urinalysis is cheap and universally available and should always be documented before initiating antiretroviral therapy.

 
   References Top

1.Agbaji OO, Onu A, Agaba PE, Muazu MA, Falang KD, Idoko JA. Predictors of impaired renal function among HIV infected patients commencing highly active antiretroviral therapy in Jos, Nigeria. Niger Med J 2011;52:182-5.  Back to cited text no. 1
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2.Phair J, Palella F. Renal disease in HIV-infected individuals. Curr Opin HIV AIDS 2011;6:285-9.  Back to cited text no. 2
    
3.Gazzard BG, Anderson J, Babiker A, Boffito M, Brook G, Brough G, et al. British HIV Association Guidelines for the treatment of HIV-1-infected adults with antiretroviral therapy 2008. HIV Med 2008;9:563-608.  Back to cited text no. 3
    
4.Allen M, Harry TC. Monitoring renal function in HIV patients using Tenofovir in East Anglia, UK. Sex Health Matters 2010;11:15-22.  Back to cited text no. 4
    
5.Agbaji OO, Agaba PA, Idoko JA, Taiwo B, Murphy R, Kanki P, et al. Temporal Changes in Renal Glomerular Function Associated with the use of Tenofovir Disoproxil Fumarate in HIV-Infected Nigerians. West Afr J Med 2011;30:164-8.  Back to cited text no. 5
    
6.Msango L, Downs JA, Kalluvya SE, Kidenya BR, Kabangila R, Johnson WD Jr, et al. Renal dysfunction among HIV-infected patients starting antiretroviral therapy. AIDS 2011;25:1421-5.  Back to cited text no. 6
    




 

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