Risk factors for chronic kidney disease among human immunodeficiency virus-infected patients: A European case control study

• Published in: Clinical nephrology Vol. 75; no. 6; p. 518
• Main Authors: Di Biagio, A, Rosso, R, Vitale, F, Cardinale, F, Sormani, M P, Secondo, G, Di Stefano, L, Viscoli, C
• Format: Journal Article
• Language: English
• Published: Germany 01-06-2011
• Subjects: Acquired Immunodeficiency Syndrome - complications; Adult; Anti-HIV Agents - adverse effects; Case-Control Studies; Creatinine - urine; Cross-Sectional Studies; Female; Glomerular Filtration Rate; Hepatitis C - complications; HIV Infections - complications; HIV-1; Humans; Italy - epidemiology; Kidney Failure, Chronic - chemically induced; Kidney Failure, Chronic - epidemiology; Kidney Failure, Chronic - etiology; Kidney Failure, Chronic - virology; Logistic Models; Male; Middle Aged; Prospective Studies; Proteinuria - diagnosis; Risk Factors; Statistics, Nonparametric; Substance Abuse, Intravenous - complications; Time Factors; Italy
• ISSN: 0301-0430
• DOI: 10.5414/CNP75518

Renal dysfunction is a common complication in human immunodeficiency virus (HIV)-infected patients and can be attributed to direct viral damage, comorbidities or drug toxicity. The aim of this study was to assess cross-sectional correlates of renal damage in a contemporary European cohort of patients.
We performed a case-control study from our cohort of 750 HIV-infected adults over a period of 5 months. We assessed renal damage by either proteinuria (≥+ on urine dipstick), reduced creatinine clearance (< 60 ml/min) or reduced estimated glomerular filtration rate (eGFR) of < 60 ml/ min/1.73 m2. The characteristics of cases and controls were compared in analysis and in multivariate logistic regression models with stepwise selection.
Approximately 50% of the screened 106 patients had a qualifying abnormality. Altogether, we identified 55 cases with 110 age- and gender-matched controls. Mean eGFR was 90.7 (4.8) for cases vs. 106.1 (2.3) ml/min/1.73 m2 for controls (p = 0.001). Cases had a longer duration of HIV infection, more complex regimen, longer exposure to antiretroviral therapy and a more frequent diagnosis of acquired immune-deficiency syndrome (AIDS) and hepatitis C virus (HCV) infection. In the logistic multivariate model, renal damage remained significantly associated with longer known duration of HIV infection (OR 2.88, 95% CI: 1.28 - 6.46, p = 0.01), AIDS defining condition (OR 1.09 95% CI: 1.03 - 1.16, p = 0.002) female gender (OR 2.01, 95% CI: 0.96 - 4.18, p = 0.06), and HCV infection (OR 2.12, 95% CI: 0.99 - 4.52, p = 0.05).
Duration, antiretroviral regimen and coincidental HCV impacted the frequency of renal abnormalities in our patients.