Renal sonographic parameters in human immunodeficiency virus - infected subjects and relationship to CD4 cell count

Nephropathy in human immunodeficiency virus (HIV)-infected patient is common and constitutes a major cause of endstage kidney disease. CD4 cell count is a useful parameter in the assessment of the degree of immunosuppression among HIV-infected patients. Manifestations of renal disease are thought to be more profound when CD4 cell counts are low. Sonography is a safe and inexpensive method of evaluating renal disease,including renal sizes and degree of echogenicity. Ultrasound examination was carried out prospectively at the University of Benin Teaching Hospital on 120 HIV-infected patients comprising 45 males (37.5%) and 75 females (63.5%). Renal sizes and degree of echogenicity were assessed. Correlation with CD4 + cell counts of the patients was done. Mean CD4 cell count mean was 18.34 ± 142.18 cells/mm 3 with female patients having a significantly higher cell count compared with males. Seventy-four patients (63.8%) had a cell count of 200 cells/mm 3 . Renal sizes were normal in 85%,small in 7%,and large in 8% of patients. Fifty patients (41.7%) had increased renal echogenicity and 8 (6.7%) had severe increased echo-texture. CD4 cell count did not correlate with renal sizes and echotexture. Results of this study show that large kidneys and marked increase in renal echotexture were not common even in a population of patients where the majority had CD4 cell count 200 cells/mm 3 . This study shows that increased renal sizes and degree of echogenicity alone are not useful predictors of renal involvement in HIV/AIDS.