title: Classification of human immunodeficiency virus-infected patients with chronic kidney disease using a combination of proteinuria and estimated glomerular filtration rate.
abstract: BACKGROUND
  In 2012, the Kidney Disease: Improving Global Outcomes (KDIGO) updated the 2002 Kidney Disease Outcomes Quality Initiative (KDOQI) clinical practice guideline for chronic kidney disease (CKD). The 2012 KDIGO guideline elaborated the identification and prognosis of CKD by combining albuminuria with estimated glomerular filtration rate (eGFR). Identification of CKD with a high risk for a poor prognosis was investigated in human immunodeficiency virus (HIV)-infected individuals by applying the new guideline.
  
  
  METHODS
  A total of 1,447 HIV-infected patients (1,351 male, 96 female; mean age 44.4 ± 11.5 years) were classified using a combination of eGFR and dipstick proteinuria, as a convenient alternative to albuminuria. Proteinuria was classified into 3 grades-(A1) - and +/- , (A2) 1+ and 2+ , and (A3) 3+ and 4+. eGFR was classified into 6 grades-(G1) ≤90, (G2) 60-89, (G3a) 45-59, (G3b) 30-44, (G4) 15-29, and (G5) <15 mL/min/1.73 m(2).
  
  
  RESULTS
  Mean CD4 cell count was 487 ± 214 /μL, with 80.7 % of patients having an undetectable HIV-RNA level. The prevalence of CKD stage ≤2 and stage ≥3 classified according to KDOQI staging was 93.4 and 6.6 %, respectively. Using the new KDIGO classification, the prevalence of CKD with either a low (green) or moderately increased (yellow) risk was 96.9 %, while the prevalence for a high (orange) and very high (red) risk was 3.1 %.
  
  
  CONCLUSIONS
  The use of the new KDIGO classification may reduce the prevalence of HIV-infected CKD individuals who are at high risk for a poor prognosis by nearly a half.
authors: Department of Infectious Diseases, Tokyo Metropolitan Komagome Hospital, Bunkyo-Ku, Japan.
authors: Naoki
authors: N
authors: Yanagisawa
authors: Takashi
authors: T
authors: Muramatsu
authors: Yasuyuki
authors: Y
authors: Yamamoto
authors: Ken
authors: K
authors: Tsuchiya
authors: Kosaku
authors: K
authors: Nitta
authors: Atsushi
authors: A
authors: Ajisawa
authors: Katsuyuki
authors: K
authors: Fukutake
authors: Minoru
authors: M
authors: Ando
mesh_terms: D016263:AIDS-Associated Nephropathy / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology; D000328:Adult; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D011507:Proteinuria / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology; D011934:Reagent Strips; D051436:Renal Insufficiency, Chronic / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology; D012720:Severity of Illness Index; D016482:Urinalysis / Q000295:instrumentation; D019562:Viral Load
chemical_list: D011934:Reagent Strips
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