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 / mm3 with female patients having a significantly higher cell count compared with males. Seventy-four patients (63.8 %) had a cell count of < 200 cells / mm3. 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 echotexture. 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 / mm3. This study shows that increased renal sizes and degree of echogenicity alone are not useful predictors of renal involvement in HIV / AIDS.