title: [Crucial risk factors for renal function deterioration of HIV-infected patients at the AIDS Clinic in Rambam Hospital].
abstract: BACKGROUND
  Since the introduction of new and efficient antiretroviraL treatment (ART), mortality and morbidity due to HIV infections have been greatly reduced. However, there is a growing incidence of chronic diseases, such as cardiovascular, metabolic, bone and renal diseases.
  
  
  OBJECTIVE
  To examine the impact of HIV infection on renal functions over time and to define risk factors which contribute to the change in renal functions.
  
  
  METHODS
  We screened 600 out of the 800 patients who are registered in the Institute for Immunology, Allergy and AIDS at the Rambam Medical Center, Haifa. We collected data from the typed and computerized medical fites of the patients. Finally, for 136 patients under surveillance between the years 2005-2010 there was sufficient data to meet the inclusion and exclusion criteria. We followed the renal function, presented by the estimated glomerular filtration rate (eGFR) and quantified the change in GFR each year. Then, we determined the risk factors contributing to the change in renal function, by using a multi-variant model.
  
  
  RESULTS
  We found an average yearly decline of 4.83 mt/ min/1.73 m2 body surface area during the period 2005- 2010. We also found that co-infection with HCV and treatment by the antiretrovirat drug Tenofovir are significantly associated with the decline in renal function among our patients [p=0. 0.14 and 0.045 respectively).
  
  
  CONCLUSIONS
  There is a persistent decline in renal function, overtime, in HIV patients. This decline is significantly higher than the change observed in age- and sex-matched healthy general populations. Co-infection with HCV and treatment by the antiretroviral drug Tenofovir are substantial risk factors for eGFR.
authors.affiliation: Institute for Immunulogy, Allergy & AIDS, Rambam Medical Center Haifa, Israel. ed_shahar@rambam.health.gov.il
authors.forename: Eduardo
authors.initials: E
authors.lastname: Shahar
authors.forename: Fida
authors.initials: F
authors.lastname: Mugrabi
authors.forename: Eynat
authors.initials: E
authors.lastname: Kedem
authors.forename: Gamal
authors.initials: G
authors.lastname: Hassoun
authors.forename: Shimon
authors.initials: S
authors.lastname: Pollack
mesh_terms: D000225:Adenine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects; D060085:Coinfection; D005260:Female; D005919:Glomerular Filtration Rate; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008501:Medical Records, Problem-Oriented / Q000706:statistics & numerical data; D008875:Middle Aged; D015233:Models, Statistical; D063065:Organophosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D051437:Renal Insufficiency / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D000068698:Tenofovir
chemical_list: D019380:Anti-HIV Agents; D063065:Organophosphonates; D000068698:Tenofovir; D000225:Adenine