title: Increased risk of dialysis and end-stage renal disease among HIV patients in Denmark compared with the background population.
abstract: BACKGROUND
  HIV patients have increased risk of impaired renal function. We aimed to estimate the incidence of any renal replacement therapy (aRRT) and start of chronic renal replacement therapy (cRRT) among HIV patients compared with population controls.
  
  
  METHODS
  In a nationwide, population-based cohort study we analysed incidence rates (IR), incidence rate ratios (IRR) and risk factors for aRRT and cRRT among HIV patients compared with an age- and gender-matched population control cohort using Poisson regression.
  
  
  RESULTS
  We identified 5300 HIV patients and 53 000 population controls. The IRs per 10 000 person-years of aRRT and cRRT among HIV patients were 15.9 (95% CI: 12.5-20.1) and 4.4 (95% CI: 2.8-6.9), respectively. The IRR was 4.7 (95% CI: 3.5-6.2) for aRRT and 3.6 (95% CI: 2.2-6.0) for cRRT compared with population controls. Risk of aRRT was increased during the first year after HIV diagnosis [IRR 3.5 (95% CI: 1.5-8.1)], after a diagnosis of AIDS [IRR 2.3 (95% CI: 1.3-3.9)], in intravenous drug users [IRR 6.0 (95% CI: 2.9-12.2)] and in patients with hypertension [IRR 7.0 (95% CI: 3.7-13.2)]. Factors associated with increased risk of cRRT were hypertension [IRR 20 (95% CI: 6.8-61)] and baseline eGFR < 60 mL/min pr. 1.73 m(2) [IRR 7.8 (95% CI: 1.2-50)]. Exposure to tenofovir and/or atazanavir was not associated with risk of aRRT or cRRT.
  
  
  CONCLUSIONS
  The risk of aRRT is increased more than 4-fold and the risk of cRRT is increased more than 3-fold in HIV patients in Denmark compared with the background population. We found no association between exposure to tenofovir, atazanavir or the combination of the two and risk of aRRT or cRRT.
authors: Faculty of Health Sciences, University of Copenhagen, 1455 København K, Denmark Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark.
authors: Magnus G
authors: MG
authors: Rasch
authors: Faculty of Health Sciences, University of Copenhagen, 1455 København K, Denmark Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark.
authors: Marie
authors: M
authors: Helleberg
authors: Department of Nephrology, Copenhagen University Hospital, Rigshospitalet, Denmark.
authors: Bo
authors: B
authors: Feldt-Rasmussen
authors: Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark.
authors: Gitte
authors: G
authors: Kronborg
authors: Department of Infectious Diseases, Aarhus University Hospital, Skejby, Aarhus, Denmark.
authors: Carsten S
authors: CS
authors: Larsen
authors: Department of Infectious Diseases, Odense University Hospital, Odense, Denmark.
authors: Court
authors: C
authors: Pedersen
authors: Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
authors: Gitte
authors: G
authors: Pedersen
authors: Faculty of Health Sciences, University of Copenhagen, 1455 København K, Denmark.
authors: Jan
authors: J
authors: Gerstoft
authors: Faculty of Health Sciences, University of Copenhagen, 1455 København K, Denmark.
authors: Niels
authors: N
authors: Obel
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000069446:Atazanavir Sulfate; D015331:Cohort Studies; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000627:therapeutic use; D063065:Organophosphonates / Q000627:therapeutic use; D011725:Pyridines / Q000627:therapeutic use; D006435:Renal Dialysis / Q000706:statistics & numerical data; D017582:Renal Replacement Therapy / Q000706:statistics & numerical data*; D012307:Risk Factors; D000068698:Tenofovir
chemical_list: D019380:Anti-HIV Agents; D009842:Oligopeptides; D063065:Organophosphonates; D011725:Pyridines; D000069446:Atazanavir Sulfate; D000068698:Tenofovir; D000225:Adenine
keywords: CKD; Dialysis; ESRD; HIV; eGFR; renal replacement therapy