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- Title
Higher Prevalence and Faster Progression of Chronic Kidney Disease in Human Immunodeficiency Virus-Infected Middle-Aged Individuals Compared With Human Immunodeficiency Virus-Uninfected Controls.
- Authors
Kooij, Katherine W.; Vogt, Liffert; Wit, Ferdinand W. N. M.; van der Valk, Marc; van Zoest, Rosan A.; Goorhuis, Abraham; Prins, Maria; Post, Frank A.; Reiss, Peter; AGEhIV Cohort Study
- Abstract
<bold>Background: </bold>Human immunodeficiency virus (HIV)-infected individuals are at increased risk of chronic kidney disease (CKD). Human immunodeficiency virus infection, traditional CKD risk factors, and combination antiretroviral therapy (cART) may all contribute.<bold>Methods: </bold>We compared prevalence of renal impairment (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73m2), albuminuria (albumin/creatinine ratio ≥3 mg/mmol), and proximal renal tubular dysfunction (retinol-binding protein/creatinine ratio >2.93μg/mmol and/or fractional phosphate excretion >20% with plasma phosphate <0.8 mmol/L) in 596 HIV-infected and 544 HIV-uninfected AGEhIV Cohort Study participants. We also assessed whether being HIV-infected on cART, with follow-up censored when cART regimen was modified, was associated with greater eGFR decline or worsening albuminuria (increase ≥10%/year with change in albuminuria category).<bold>Results: </bold>Human immunodeficiency virus infection was independently associated with renal impairment (adjusted odds ratio [aOR] = 2.1; 95% confidence interval [CI] = 1.0-4.4), albuminuria (aOR = 5.8; 95% CI = 3.7-9.0), and proximal renal tubular dysfunction (aOR = 7.0; 95% CI = 4.9-10.2]). Among 377 HIV-infected and 479 HIV-uninfected individuals (median follow-up = 3.9/4.1 years, respectively) included in longitudinal analyses, being HIV-infected and remaining on unmodified cART was independently associated with greater eGFR decline (-0.56; 95% CI = -0.87 to -0.24 mL/min/1.73m2/year) and worsening albuminuria (aOR = 2.3; 95% CI = 1.3-4.0).<bold>Conclusions: </bold>In these middle-aged individuals, HIV infection was independently associated with renal impairment, albuminuria, and proximal renal tubular dysfunction. Human immunodeficiency virus-infected individuals on cART (predominantly containing tenofovir disoproxil fumarate) were also more likely to experience eGFR decline and worsening albuminuria compared with HIV-uninfected individuals.
- Subjects
HIV infections; CHRONIC kidney failure; ALBUMINURIA; RENAL tubular transport disorders; TENOFOVIR; HIGHLY active antiretroviral therapy; GLOMERULAR filtration rate; DISEASE risk factors; HIV infection complications; CHRONIC kidney failure complications; ANTI-HIV agents; LONGITUDINAL method; MULTIVARIATE analysis; PHOSPHATES; LOGISTIC regression analysis; DISEASE prevalence; CASE-control method; DISEASE progression; DISEASE complications
- Publication
Journal of Infectious Diseases, 2017, Vol 216, Issue 6, p622
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/jix202