Factors associated with renal dysfunction within an urban HIV-infected cohort in the era of highly active antiretroviral therapy

Edgar Turner Overton, D. Nurutdinova, J. Freeman, W. Seyfried, K. E. Mondy

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Background: Kidney disease remains a prevalent problem in HIV care. The contribution of highly active antiretroviral therapy (HAART), HIV disease factors and traditional factors needs further evaluation. Methods: A cross-sectional study of all patients seen at an HIV outpatient clinic during 2005 was performed. All data were collected from medical record review. Multivariate regression modelling was used to identify independent predictors of lower glomerular filtration rate (eGFR) and chronic renal failure (CRF) from factors significant in univariate analysis. eGFR was calculated using the simplified modification of diet in renal disease equation. Results were compared with those for persons from the National Health and Nutrition Examination Survey (NHANES) matched for age, race and gender. Results: Of 845 HIV-infected persons, 64% were men and 34% were Caucasian, and the mean age was 39.8 years. Thirty per cent of the patients had proteinuria and 43% had eGFR < 90 mL/min/1.73 m2. Persons on HAART (63%) had a lower mean eGFR than those not on HAART (92.0 vs. 101.6). In multivariate analyses, significant predictors of eGFR decline were diagnoses of hypertension, hyperlipidaemia, proteinuria, use of tenofovir or stavudine, and lower viral load. Compared with those in NHANES, HIV-infected persons had a lower mean eGFR (94.9 vs. 104.2) and a higher prevalence of CRF (8% vs. 2%). Conclusion: In this cohort, the prevalence of CRF is low, but remains higher than that of the general population. Clinicians should routinely screen for early asymptomatic kidney disease to address risk factors that can be treated.

Original languageEnglish (US)
Pages (from-to)343-350
Number of pages8
JournalHIV Medicine
Volume10
Issue number6
DOIs
StatePublished - 2009

Fingerprint

Highly Active Antiretroviral Therapy
HIV
Kidney
Chronic Kidney Failure
Tenofovir
Nutrition Surveys
Kidney Diseases
Proteinuria
Stavudine
Diet Therapy
Asymptomatic Diseases
Ambulatory Care Facilities
Hyperlipidemias
Viral Load
Glomerular Filtration Rate
Medical Records
Multivariate Analysis
Cross-Sectional Studies
Hypertension
Population

Keywords

  • AIDS
  • Chronic kidney disease
  • Highly active antiretroviral therapy
  • HIV

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)
  • Health Policy

Cite this

Factors associated with renal dysfunction within an urban HIV-infected cohort in the era of highly active antiretroviral therapy. / Overton, Edgar Turner; Nurutdinova, D.; Freeman, J.; Seyfried, W.; Mondy, K. E.

In: HIV Medicine, Vol. 10, No. 6, 2009, p. 343-350.

Research output: Contribution to journalArticle

Overton, Edgar Turner ; Nurutdinova, D. ; Freeman, J. ; Seyfried, W. ; Mondy, K. E. / Factors associated with renal dysfunction within an urban HIV-infected cohort in the era of highly active antiretroviral therapy. In: HIV Medicine. 2009 ; Vol. 10, No. 6. pp. 343-350.
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AU - Mondy, K. E.

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N2 - Background: Kidney disease remains a prevalent problem in HIV care. The contribution of highly active antiretroviral therapy (HAART), HIV disease factors and traditional factors needs further evaluation. Methods: A cross-sectional study of all patients seen at an HIV outpatient clinic during 2005 was performed. All data were collected from medical record review. Multivariate regression modelling was used to identify independent predictors of lower glomerular filtration rate (eGFR) and chronic renal failure (CRF) from factors significant in univariate analysis. eGFR was calculated using the simplified modification of diet in renal disease equation. Results were compared with those for persons from the National Health and Nutrition Examination Survey (NHANES) matched for age, race and gender. Results: Of 845 HIV-infected persons, 64% were men and 34% were Caucasian, and the mean age was 39.8 years. Thirty per cent of the patients had proteinuria and 43% had eGFR < 90 mL/min/1.73 m2. Persons on HAART (63%) had a lower mean eGFR than those not on HAART (92.0 vs. 101.6). In multivariate analyses, significant predictors of eGFR decline were diagnoses of hypertension, hyperlipidaemia, proteinuria, use of tenofovir or stavudine, and lower viral load. Compared with those in NHANES, HIV-infected persons had a lower mean eGFR (94.9 vs. 104.2) and a higher prevalence of CRF (8% vs. 2%). Conclusion: In this cohort, the prevalence of CRF is low, but remains higher than that of the general population. Clinicians should routinely screen for early asymptomatic kidney disease to address risk factors that can be treated.

AB - Background: Kidney disease remains a prevalent problem in HIV care. The contribution of highly active antiretroviral therapy (HAART), HIV disease factors and traditional factors needs further evaluation. Methods: A cross-sectional study of all patients seen at an HIV outpatient clinic during 2005 was performed. All data were collected from medical record review. Multivariate regression modelling was used to identify independent predictors of lower glomerular filtration rate (eGFR) and chronic renal failure (CRF) from factors significant in univariate analysis. eGFR was calculated using the simplified modification of diet in renal disease equation. Results were compared with those for persons from the National Health and Nutrition Examination Survey (NHANES) matched for age, race and gender. Results: Of 845 HIV-infected persons, 64% were men and 34% were Caucasian, and the mean age was 39.8 years. Thirty per cent of the patients had proteinuria and 43% had eGFR < 90 mL/min/1.73 m2. Persons on HAART (63%) had a lower mean eGFR than those not on HAART (92.0 vs. 101.6). In multivariate analyses, significant predictors of eGFR decline were diagnoses of hypertension, hyperlipidaemia, proteinuria, use of tenofovir or stavudine, and lower viral load. Compared with those in NHANES, HIV-infected persons had a lower mean eGFR (94.9 vs. 104.2) and a higher prevalence of CRF (8% vs. 2%). Conclusion: In this cohort, the prevalence of CRF is low, but remains higher than that of the general population. Clinicians should routinely screen for early asymptomatic kidney disease to address risk factors that can be treated.

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