Estimated glomerular filtration rate, chronic kidney disease and antiretroviral drug use in HIV-positive patients

  title={Estimated glomerular filtration rate, chronic kidney disease and antiretroviral drug use in HIV-positive patients},
  author={Amanda Mocroft and Ole Kirk and Peter Reiss and St{\'e}phane De Wit and Dalibor Sedl{\'a}{\vc}ek and Marek Beniowski and Josep Mar{\'i}a Gatell and Andrew N Phillips and Bruno Ledergerber and Jens D. Lundgren},
Objectives:Chronic kidney disease (CKD) in HIV-positive persons might be caused by both HIV and traditional or non-HIV-related factors. Our objective was to investigate long-term exposure to specific antiretroviral drugs and CKD. Design:A cohort study including 6843 HIV-positive persons with at least three serum creatinine measurements and corresponding body weight measurements from 2004 onwards. Methods:CKD was defined as either confirmed (two measurements ≥3 months apart) estimated glomerular… 

Predictors of advanced chronic kidney disease and end-stage renal disease in HIV-positive persons

Neither current nor recent antiretroviral drug use predicted advanced CKD/ESRD during 6 years median follow-up in a large, heterogenenous and primarily white cohort.

Risk factors for chronic kidney disease in a large cohort of HIV-1 infected individuals initiating antiretroviral therapy in routine care

ART was associated with reduced CKD risk in association with CD4 cell restoration and plasma viral load suppression, despite an increased CKDrisk that was associatedWith initial regimens that included tenofovir and rPI.

Association between antiretroviral exposure and renal impairment among HIV-positive persons with normal baseline renal function: the D:A:D study.

Tenofovir, ritonavir-boosted atazanavir, and ritonvir- Boosted lopinavir use were independent predictors of chronic renal impairment in HIV-positive persons without preexisting renal impairment.

Renal function and incidence of chronic kidney disease in HIV patients: A Danish cohort study

Tenofovir and indinavir reduce eGFR, while time with HIV only has a modest effect on this parameter, which is associated with an increased risk of CKD, especially when receiving HAART regimens containing the combination ten ofovir/atazanavir.

Long-term kidney function, proteinuria, and associated risks among HIV-infected and uninfected men

Longitudinal kidney function decline was associated with HAART use but no individual antiretroviral drug, and traditional kidney disease risks, and proteinuria was nearly seven times more common in HAART-treated men than HIV− men, reflected recent eGFR decline and predicted subsequent eG FR decline.

Role of Traditional Risk Factors and Antiretroviral Drugs in the Incidence of Chronic Kidney Disease, ANRS CO3 Aquitaine Cohort, France, 2004–2012

In patients with eGFR between 60 and 80 mL/min/1.73 m2, a thorough control of CKD risk factors is warranted, and the use of TDF, especially when co-administered with PIs, should be mentioned as a relative contraindication in presence of at least one of these risk factors.

Glomerular Dysfunction and Associated Risk Factors over 4–5 Years following Antiretroviral Therapy Initiation in Africa

Investigation of long-term renal function in HIV-infected adults initiating antiretroviral therapy with a CD4(+) T-cell count in Africa suggested that first-line ART, including tenofovir, can be given safely without routine renal function monitoring.

Prevalence and risk factors of mild chronic renal failure in HIV-infected patients: influence of female gender and antiretroviral therapy

  • M. CristelliJ. Trullàs J. Miro
  • Medicine, Biology
    The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases
  • 2018

Prevalence and Risk Factors Associated to Chronic Kidney Disease in HIV-Infected Patients on HAART and Undetectable Viral Load in Brazil

A more frequent monitoring of renal function is suggested, especially for those with risk factors to early identify renal impairment, was a common finding in this cohort of patients and was related to hypertension, time on HAART and tenofovir exposure.

Chronic renal failure among HIV-1-infected patients

Among antiretrovirals, only exposure to indinavir or tenofovir was associated with increased odds of CRF, and highly consistent results were seen using the MDRD formula.

Severe renal dysfunction and risk factors associated with renal impairment in HIV-infected adults in Africa initiating antiretroviral therapy.

  • A. ReidW. Stöhr D. Gibb
  • Medicine
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2008
Despite screening, mild-to-moderate baseline renal impairment was relatively common, but these participants had greatest increases in eGFR after starting ART, with small but statistically significant differences between regimens.

HIV-infected persons continue to lose kidney function despite successful antiretroviral therapy

Although ART appears to help curb kidney function decline, patients who achieved durable viral suppression continue to manifest substantial loss of eGFR, which may be attributable to treatment-related factors, intermittent viremia, and traditional risk factors for kidney disease.

Prevalence of Chronic Kidney Disease in an Urban HIV Infected Population

Substantial minorities of HIV-infected patients have CKD, and HTN, AA race, or HTN and DM were the only significant predictors of CKD.

A Comparison of the Predictive Performance of Different Methods of Kidney Function Estimation in a Well-Characterized HIV-Infected Population

The findings support the preferential use of the MDRD formula in the treated HIV population and suggest that there are no HIV-specific factors that limit equation applicability.

Chronic kidney disease incidence, and progression to end-stage renal disease, in HIV-infected individuals: a tale of two races.

The results of this study suggest that African American-white disparities in HIV-related ESRD are explained predominantly by a more aggressive natural disease history in African Americans and less by racial differences in CKD incidence.

Association between renal disease and outcomes among HIV-infected women receiving or not receiving antiretroviral therapy.

  • L. SzczechD. Hoover K. Anastos
  • Medicine
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2004
Proteinuria and an elevated creatinine level were associated with an increased risk of death and development of ADI, which may reflect the direct role of the kidney in modulating HIV disease, or they may act as markers of greater comorbidity.

Impact of Tenofovir on Renal Function in HIV-Infected, Antiretroviral-Naive Patients

Tenofovir is associated with greater effect on decline in renal function and a higher risk of proximal tubular dysfunction in antiretroviral naïve patients initiating antireTroviral therapy.

Observations on HIV‐Associated Renal Disease in the Era of Highly Active Antiretroviral Therapy

Patients who received HAART maintained stable renal function, whereas patients who did not required dialysis therapy or died with advanced renal failure seemed to improve renal outcomes in patients with HIV and renal disease.

The clinical characteristics and antiretroviral dosing patterns of HIV-infected patients receiving dialysis.

The high prevalence of coinfection with hepatitis C as well as the wide variations in dosing patterns for antiretroviral medications are areas that require further investigation to minimize morbidity and mortality among this group.