Association between Vitamin D and Renal Function Among Ghanaian HIV/AIDS Patients

Abstract

The prevalence of HIV among Ghanaian youth ranges from 2.4% to 3.5%. Many deaths of HIV patients are caused by complications like renal and cardiovascular diseases. Rapid replication of HIV which is favored by increased oxidative stress and the attack of reactive oxidative species (ROS) on the CD4+ T-cells are the major causes of CD4+ T-cell depletion in HIV/AIDS patients. Effective circulating antioxidant and minerals may play important role in curtailing the deleterious effect of ROS. HIV-infected persons have a high prevalence of vitamin D deficiency and insufficiency. Some antiretroviral drugs are known to interfere with vitamin D metabolism causing deficiency of vitamin D. Thus, the intake of micronutrients including vitamin D is encouraged. Micronutrients like vitamin D when taken in higher doses can lead to hypercalcemia. Hypercalcemia usually contributes to calcium deposits in the kidney causing kidney stones, kidney damage and eventually kidney failure. General Aim: This study aimed at determining the serum vitamin D levels and establishing its association with kidney function among Ghanaian HIV/AIDS patients on HAART with or without vitamin supplements Methodology: This study was a cross-sectional study carried out at the Fevers Unit of Korle-Bu Teaching Hospital and the Chemical Pathology Department of the College of Health Science, University of Ghana. Two hundred participants confirmed to be positive of HIV-1 and or HIV-2 were selected randomly from the Fevers Unit of Korle-Bu Teaching Hospital. Patients taking HAART and vitamin supplement for more than six months were 100 made up of 30(30%) males and 70 (70%) females. Fifty patients on HAART and vitamin supplement for less than six months patients comprised of 17 (34%) males and 33 (66%) females. Patients not on both HAART and vitamin supplement was 50, made up of 14 (28%) males and 36 (72%) females. Blood samples obtained were analysed for 25 hydroxyvitamin D3, creatinine, serum calcium and albumin. Results The mean systolic blood pressure (SBP) of patients compared among the three groups was statistically significant (p < 0.05). However, the mean diastolic blood pressure (DBP) and body mass index (BMI) was not statistically significant in the patients taking HAART and vitamin supplement for more than six months, patients taking HAART and vitamin supplement for less than six months and those not on both HAART and vitamin supplement (p> 0.05). The mean estimated Glomerular filtration rates, albumin, calcium, creatinine and 25 hydroxyvitamin D levels were not statistically significant in the 3 categories of patients studied (p> 0.05). 25 hydroxyvitamin D levels were low (<15ng/ml) in patients on HAART and vitamin supplement for the categories (more than six months, less than six months and not on both HAART and vitamin supplement). The mean eGFR was > 60 mL/min/1.73 m2 for about 70% of the patients on HAART and vitamin supplement for more than six months, less than six months and patients not on both HAART and vitamin supplement. Low vitamin D levels were found across the various age groups. There was no correlation between 25hydroxyvitamin D and creatinine, eGFR, albumin and calcium of the patients on HAART and vitamin supplement for more than six months, less than six months and patients not on both HAART and vitamin supplement. Conclusion Long exposure to vitamin D did not cause its increased levels in circulation and did not relay any adverse effect on kidney function in Ghanaian HIV/AIDS patients receiving both antiretroviral and vitamin supplements.