Predictive factors of renal impairment in HIV-infected patients on antiretroviral therapy: Results from the VACH longitudinal cohort study
Por:
Domingo P, Suarez-Lozano I, Gutierrez F, Estrada V, Knobel H, Palacios R, Antela A, Blanco JR, Fulladosa X and VACH
Publicada:
1 sep 2019
Categoría:
Nephrology
Resumen:
Background: The use of combination antiretroviral therapy has led to dramatic improvements in the life expectancy of HIV-infected persons. As result, the HIV population is aging and increasingly facing illnesses typically seen in the elderly, such as chronic kidney disease (CKD).
Methods: A retrospective longitudinal study was conducted using data from years 2010 and 2014 in all HIV-infected persons enrolled at the Spanish VACH cohort. We analyzed the prevalence and the predictive factors for developing CKD (estimated glomerular filtration rate, eGFR < 60 mL/min/1.73 m(2)).
Results: The CKD prevalence at baseline was 456/8968, 5.1% [4.6-5.6%]. Of 8512 HIV-positive individuals examined without CKD at baseline (73.7% male, median age 44 years-old), 2.15% developed CKD (eGFR < 60 mL/min/1.73 m(2)). The odds ratios [95%Cl] for the independent predictive factors identified were gender (male) 0.54 [0.39-0.75], age (per year) 1.08 [1.07-1.10], AIDS diagnosis 1.40 [1.03-1.91], protease inhibitor-based regimens 1.49 [1.10-2.02], hypertension 1.37 [0.94-1.99], diabetes 1.84 [1.33-2.55] and history of cardiovascular events 1.66 [0.96-2.86].
Conclusions: The prevalence and risk factors for CKD and its progression are high in the VACH cohort. Thus, preventive measures such as control of hypertension, diabetes and obesity, as well as efforts for avoiding exposure to nephrotoxic drugs, including some antiretrovirals, are warranted in this aging HIV population. (C) 2019 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U.
Filiaciones:
Domingo P:
Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Suarez-Lozano I:
Infectious Diseases Unit, Hospital Infanta Elena, Huelva, Spain
:
Infectious Diseases Unit, Hospital Universitario de Elche, Alicante, Spain
Estrada V:
Infectious Diseases Unit, Hospital Clínico San Carlos, Madrid, Spain
Knobel H:
Infectious Diseases Unit, Hospital del Mar, Barcelona, Spain
Palacios R:
Infectious Diseases Unit, Hospital Universitario Virgen de la Victoria, Malaga, Spain
Antela A:
Infectious Diseases Unit, Complexo Hospitalario Universitario, Santiago de Compostela, Spain
Blanco JR:
Infectious Diseases Unit, Hospital San Pedro, Logroño, Spain
Fulladosa X:
Nephrology Unit, Hospital Universitario de Bellvitge, Barcelona, Spain
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