Prevalence and factors associated with renal impairment in HIV-infected patients, ANRS C03 Aquitaine Cohort, France.
OBJECTIVE
The aims of the present study were to estimate the prevalence of renal impairment (RI) among HIV-infected adult patients and to investigate the associated factors.


METHODS
A cross-sectional survey was conducted in a French hospital-based cohort. Clearance of creatinine (CC) was calculated using the Cockcroft-Gault formula. Four stages of RI were defined: mild (60-90 mL/min), moderate (30-60), severe (15-30) and end stage (<15). Logistic regression models were used to investigate factors associated with RI.


RESULTS
The male/female ratio of the 2588 patients enrolled was 3:1 and the median age was 42 years. At the time of assessment of CC, the median CD4 count was 430 cells/microL and HIV plasma viral load (VL) was<50 copies/mL in 60%. The overall prevalence of RI was 39.0%: 34.2% mild, 4.4% moderate, 0.3% severe and 0.2% end-stage. Mild RI was associated with female gender [odds ratio (OR)=3.3: 95% CI 2.6-4.3)], age >50 years (OR=9.8: 7.4-13.0) and 40-50 years (OR=1.9: 1.5-2.4), body mass index (BMI) <22 kg/m(2) (OR=3.3: 2.7-4.3) and tenofovir exposure (OR=1.4: 1.0-1.9 for <1 year and OR=1.5: 1.2-2.0 for >1 year). Advanced RI (CC <60 mL/min) was associated with age >50 years (OR=5.6: 2.9-10.9) and 40-50 years (OR=2.2: 1.1-1.4), BMI <22 kg/m(2) (OR=1.5: 1.0-2.4), hypertension (OR=2.5: 1.4-2.5) and indinavir (IDV) exposure >1 year (OR=2.3: 1.5-3.6).


CONCLUSIONS
This survey confirms the high prevalence of RI in HIV-infected patients and indicates the importance of the investigation of renal function especially in women, older patients, those with a low BMI or treated with tenofovir or IDV.
Déti
E K
EK
Institut National de la Santé et de la Recherche Médicale U897, Bordeaux, F-33076, France.
Thiébaut
R
R
Bonnet
F
F
Lawson-Ayayi
S
S
Dupon
M
M
Neau
D
D
Pellegrin
J L
JL
Malvy
D
D
Tchamgoué
S
S
Dabis
F
F
Morlat
P
P
D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives; D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects; D015992:Body Mass Index; D018791:CD4 Lymphocyte Count; D003404:Creatinine / Q000097:blood*; D004812:Epidemiologic Methods; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D019469:Indinavir / Q000009:adverse effects; D007668:Kidney / Q000187:drug effects; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000009:adverse effects; D051437:Renal Insufficiency / Q000453:epidemiology* / Q000209:etiology; D000068698:Tenofovir
D019380:Anti-HIV Agents; D063065:Organophosphonates; D019469:Indinavir; D000068698:Tenofovir; D003404:Creatinine; D000225:Adenine