title: Risk factors of chronic kidney disease in HIV-infected patients.
abstract: OBJECTIVE
  The main aim of this study was determining the risk factors of chronic kidney disease (CKD) in HIV-1-infected patients.
  
  
  METHODS
  Patients were followed from seven large HIV reference centers in France that maintain prospective databases on HIV-1-infected patients. The main outcome was the time to CKD defined as two consecutive measures of estimated GFR ≤60 ml/min per 1.73 m² over ≥3 months. A Cox's model with delayed entry was used to search predictive factors of time to CKD.
  
  
  RESULTS
  From 1993 to 2006, 349 out of 7378 patients were found to have CKD. Of these, 166 had hypertension, 33 had diabetes, and 26 were antiretroviral therapy-naïve. Occurrence of acute kidney injury (hazard ratio [HR] = 2.40) and hypertension (HR = 2.39) were strongly associated with an increased risk of CKD. Patients with a durable level of CD4 count >200 cells/mm³ had a lower risk of CKD (HR = 0.63). Recent exposure to indinavir (HR = 2.03), totenofovir (HR = 1.55), and abacavir (HR = 1.37) were associated with an increased risk of CKD. Past exposure to tenofovir was also associated with an increased risk of CKD (HR = 2.23), and a trend toward significance was observed for past exposure to indinavir (HR = 1.28).
  
  
  CONCLUSIONS
  CKD was not rare in HIV-infected patients and occurs preferentially in HIV-infected patients exposed to certain ARVs, specifically abacavir, indinavir and tenofovir. This requires closer monitoring of renal function in patients exposed to one of these drugs.
authors.affiliation: INSERM UMR-S 943 Pierre & Marie Curie University, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Flandre
authors.forename: Pascal
authors.initials: P
authors.lastname: Pugliese
authors.forename: Lise
authors.initials: L
authors.lastname: Cuzin
authors.forename: Corinne Isnard
authors.initials: CI
authors.lastname: Bagnis
authors.forename: Ivan
authors.initials: I
authors.lastname: Tack
authors.forename: André
authors.initials: A
authors.lastname: Cabié
authors.forename: Isabelle
authors.initials: I
authors.lastname: Poizot-Martin
authors.forename: Christine
authors.initials: C
authors.lastname: Katlama
authors.forename: Cécile
authors.initials: C
authors.lastname: Brunet-François
authors.forename: Yazdan
authors.initials: Y
authors.lastname: Yazdanpanah
authors.forename: Pierre
authors.initials: P
authors.lastname: Dellamonica
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000009:adverse effects; D002908:Chronic Disease; D005260:Female; D005602:France / Q000453:epidemiology; D005919:Glomerular Filtration Rate; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
chemical_list: D044966:Anti-Retroviral Agents