STUDY LIMITATIONS

There were a number of limitations in the study. Firstly, due to the retrospective nature of the study, some information (including kidney size to confirm CKD) and laboratory data were not available and patients were lost to follow up. Secondly, the MDRD formula was used, which may have

overestimated the eGFR in our patients due to the generally lower muscle mass in this group of patients. The small numbers within the histological groups was another limitation and larger studies will be needed to confirm the results of this study. In addition, due to the relatively small number of patients on ACE-Is their impact on proteinuria and renal function could not be assessed.

40

7. CONCLUSION

Our findings demonstrate that HIV patients with CKD respond well to HAART. This is reflected in improvement in eGFR and improvement in the level of proteinuria. Baseline low eGFR was

associated with a poor renal outcome suggesting that initiation of HAART earlier in the course of the disease, before severe renal dysfunction has developed, improves renal outcomes and reduces the burden of HIV CKD. Patients who presented with persistent renal disease despite HAART were less likely to recover renal function, which also suggests implementing the recommendations for earlier diagnosis and treatment of renal disease in HIV patients.

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