Abstract
This study assessed urine creatinine in spot and 24-hour samples in HIV and non-HIV population. We categorized dilute urine as a 24-hour urine creatinine <300 mg, concentrated urine as a 24-hour urine creatinine >3000 mg, and normal urine as a 24-hour urine creatinine 300–3000 mg. Association of variables with creatinine was evaluated. In HIV subjects, the mean spot urine creatinine was 137.21 ± 98.47 mg/dl and a 24-hour urine creatinine was 1507 ± 781 mg. The prevalence of dilute urine was 0.5%, normal urine 93.1%, and concentrated urine 6.4%. 20-hour urine creatinine was associated with serum LDL, and HDL. Concentrated urine was correlated with a 24-hour urine osmolality (r = 0.95), serum HDL (r = −0.73), CD4 cells count (r = −0.71), and BMI (r = 0.74). Dyslipidemia was common in HIV subjects with concentrated urine. In non-HIV subjects, the mean spot urine creatinine was 148 ± 167 mg/dl and the 24-hour urine creatinine was 1203 ± 316 mg. The 24-hour urine creatinine was within the normal range. The spot urine creatinine significantly correlated with BMI, spot urine protein, spot urine osmolality, 24-hour urine protein, 24-hour urine creatinine, serum creatinine, serum cholesterol, and serum LDL. Conversely, the 24-hour urine creatinine significantly correlated with 24-hour urine volume, serum creatinine, and serum cholesterol. The spot urine protein and 24-hour urine protein were predictors of spot urine creatinine. Serum creatinine was a predictor of 24-hour urine creatinine. Proteinuric renal abnormalities were common.
Highlights
This study noted the prevalence of dilute urine or low urine creatinine of 0.5% and concentrated urine or high urine creatinine of 6.4% in HIV patients
It further showed that high urine creatinine very strongly correlated with 24-hour urine osmolality (r = 0.95), body mass index (r = 0.74), CD4 cell count (r = −0.71), and serum high-density lipoprotein cholesterol (r = −0.73)
Our study showed that BMI was associated with spot urine creatinine but not with 24-hour urine creatinine
Summary
Human immunodeficiency virus infection is a world healthcare burden with sub-Saharan Africa as a geographic area accounting for about 70% of HIV-infected persons [1]. In Nigeria the prevalence of HIV is 3.7% [1]. HIV infection directly or indirectly affects most organs of the body [2]. Tons of physiological responses are altered by HIV disease process [3–5]. Creatinine is produced by the muscles, degraded within the liver, and efficiently excreted by the kidney at a rate that is constant but is modulated by weight, gender, and age [6]. Physiologic, and disease conditions may impact on daily urine creatinine excretion. Excretion of creatinine is further altered by exogenous substances such as cocaine and heavy metals which include arsenic and cadmium seen within the bioenvironment related to environmental pollution. Urine creatinine is employed in monitoring bioenvironmental pollutants and substance use [7–9]
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