TY - JOUR
T1 - Factores predictivos de insuficiencia renal en pacientes infectados por el VIH que reciben tratamiento antirretroviral
T2 - resultados del estudio de cohortes longitudinal VACH
AU - Domingo, Pere
AU - Suarez-Lozano, Ignacio
AU - Gutierrez, Félix
AU - Estrada, Vicente
AU - Knobel, Hernando
AU - Palacios, Rosario
AU - Antela, Antonio
AU - Blanco, José Ramón
AU - Fulladosa, Xavier
PY - 2019/9/1
Y1 - 2019/9/1
N2 - 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 m2). 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 m2). The odds ratios [95%CI] 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]. Conclusion: 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.
AB - 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 m2). 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 m2). The odds ratios [95%CI] 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]. Conclusion: 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.
KW - Ageing
KW - Diabetes
KW - Human immunodeficiency virus
KW - Hypertension
KW - Renal impairment
KW - Renal insufficiency
KW - Spain
KW - Tenofovir
KW - Tenofovir disoproxil fumarate
UR - http://www.scopus.com/inward/record.url?scp=85071997168&partnerID=8YFLogxK
U2 - 10.1016/j.nefroe.2019.09.001
DO - 10.1016/j.nefroe.2019.09.001
M3 - Artículo
C2 - 31027896
AN - SCOPUS:85071997168
SN - 0211-6995
VL - 39
SP - 497
EP - 505
JO - Nefrologia
JF - Nefrologia
IS - 5
ER -