Dialysis and renal transplantation in HIV-infected patients: a European survey.
OBJECTIVE
To determine prevalence and characteristics of end-stage renal diseases (ESRD) [dialysis and renal transplantation (RT)] among European HIV-infected patients.


METHODS
Cross-sectional multicenter survey of EuroSIDA clinics during 2008.


RESULTS
Prevalence of ESRD was 0.5%. Of 122 patients with ESRD 96 were on dialysis and 26 had received a RT. Median age was 47 years, 73% were males and 43% were black. Median duration of HIV infection was 11 years. Thirty-three percent had prior AIDS; 91% were receiving antiretrovirals; and 88% had undetectable viral load. Median CD4(+)T-cell count was 341 cells per cubic millimetre; 20.5% had hepatitis C coinfection. Most frequent causes of ESRD were HIV-associated nephropathy (46%) and other glomerulonephritis (28%). Hemodialysis (93%) was the most common dialysis modality; 34% of patients were on the RT waiting list. A poor HIV control was the reason for exclusion from RT waiting list in 22.4% of cases. All the RT recipients were all alive at the time of the survey. Acute rejection was reported in 8 patients (30%). Functioning graft was present in 21 (80%).


CONCLUSIONS
This is the first multinational cross-sectional study of ESRD among European HIV population. Low prevalence of ESRD was found. Two-thirds of patients were excluded from RT for non-HIV/AIDS-related pathologies. Most patients had a functioning graft despite a high acute rejection rate.
Trullas
Joan Carles
JC
Department of Internal Medicine, Hosp. Sant Jaume, Olot, Girona, Spain.
Mocroft
Amanda
A
Cofan
Federico
F
Tourret
Jérome
J
Moreno
Asunción
A
Bagnis
Corinne Isnard
CI
Fux
Christoph Andreas
CA
Katlama
Christine
C
Reiss
Peter
P
Lundgren
Jens
J
Gatell
Jose Maria
JM
Kirk
Ole
O
Miró
Jose M
JM
D000328:Adult; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006518:Hepatitis Viruses; D006525:Hepatitis, Viral, Human / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000453:epidemiology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis