Changing trends in the survival of dialysis patients with human immunodeficiency virus in the United States.
HIV-infected patients with end-stage renal disease have a very high morbidity and mortality. In the last decade, survival of HIV-infected patients in the United States has remarkably improved. To determine whether similar improvement in survival has occurred in HIV-infected dialysis patients, their survival was evaluated by using the United States Renal Data System database. Survival of HIV-infected dialysis patients in the United States was determined and the influence of year of initiation of dialysis, and demographic characteristics on the survival were analyzed by the Kaplan-Meier method. The effects of above variables on survival were also examined in a Cox proportional hazards model. Identified were 6166 HIV-infected patients with end-stage renal disease who received dialysis in the United States. Eighty-nine percent of the patients were black, 7.4% white, and 3% other. From 1990 to 1999, 1-yr survival of HIV-infected patients on dialysis improved from 56 to 74%, and the annual death rates declined from 458 deaths to 240 deaths per 1000 patient-years. The hazard ratio declined significantly in patients who initiated dialysis in years 1999-2000 compared with patients who initiated dialysis < or = 1990 (hazard ratio, 0.49; 95% confidence interval, 0. 40 to 0.60). Survival of HIV-infected dialysis patients has remarkably improved in the United States.
Ahuja
Tejinder S
TS
Department of Medicine, Division of Nephrology, University of Texas Medical Branch, 4200 John Sealy Annex, 301 University Boulevard, Galveston, TX 77555, USA. tahuja@utmb.edu
Grady
James
J
Khan
Shilpi
S
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000401:mortality*; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology