The impact of HIV on chronic kidney disease outcomes.
Chronic kidney disease (CKD) is a known complication of the human immunodeficiency virus (HIV) but outcomes among HIV-infected patients with kidney disease are unknown. We studied a national sample of 202,927 patients with CKD (stage 3 or higher) for death, end-stage renal disease (ESRD) and the mean annual rate of decline in estimated glomerular filtration rate (eGFR) over a median period of 3.8 years. Within this sample, 0.3% of the patients were diagnosed with HIV, 43.5% were diabetic, whereas the remainder had neither disease. In this national CKD cohort, HIV-infected black patients were at higher risk of death, a similar risk for ESRD and loss of eGFR than black patients with diabetes. HIV-infected white patients experienced higher rates of death but a lower risk of ESRD than their counterparts with diabetes. Our results highlight a need to study mortality and mechanisms of ESRD in the HIV infected population.
Choi
A I
AI
Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California 94110, USA. andy.choi@ucsf.edu
Rodriguez
R A
RA
Bacchetti
P
P
Bertenthal
D
D
Volberding
P A
PA
O'Hare
A M
AM
D016263:AIDS-Associated Nephropathy / Q000208:ethnology / Q000401:mortality* / Q000503:physiopathology; D001741:Black or African American / Q000208:ethnology; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003928:Diabetic Nephropathies / Q000208:ethnology / Q000401:mortality / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000208:ethnology / Q000401:mortality* / Q000821:virology*; D007676:Kidney Failure, Chronic / Q000208:ethnology / Q000401:mortality / Q000821:virology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000639:trends*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000208:ethnology