Prevalence and risk factors of mild chronic renal failure in HIV-infected patients: influence of female gender and antiretroviral therapy

Cristelli, Marina Pontello; Trullàs, Joan Carles; Cofan, Frederic; Rico, Nayra; Manzardo, Christian; Ambrosioni, Juan; Bedini, Josep Lluís; Moreno, Asunción; Diekmann, Fritz; Miró, José M.

doi:10.1016/j.bjid.2018.05.001

Cited by 14 publications

(13 citation statements)

References 49 publications

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“…PLHIV diagnosed with SAH are 5.8 times more likely to develop CKD compared to those who do not have SAH. This finding confirms that hypertension is a significant factor and is independently associated with the rapid decline in PLHIV’s eGFR, as found in recent international cohorts ( 23 - 24 , 39 , 41 - 42 ) .…”

Section: Discussionsupporting

confidence: 89%

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Factors associated to chronic kidney disease in people living with HIV/AIDS

Pontes

Netto

Kusumota

et al. 2020

Rev. Latino-Am. Enfermagem

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Objective: to analyze the factors associated to chronic kidney disease in people living with HIV (PLHIV). Method: a paired case-control study (4 controls for each case) carried out in a specialized care service in the Southeastern of Brazil, by analyzing PLHIV medical records. The sample consisted of 85 participants, corresponding to 17 cases and 68 controls. Pearson’s chi-square test (Χ2) and Fisher’s exact test, logistic regression, Odds Ratio (OR), 95% Confidence Interval (CI) and p<0.05 were used. SPSS version 25.0 and R Core Team, 2018 version 3.5.1 were used. Results: the factors associated with chronic kidney disease identified in this study were the following: presence of Systemic Arterial Hypertension [OR=5.8, CI (95%)=1.84-18.42, p=0.001] and use of nephrotoxic anti-retrovirals in the previous therapeutic regimen [OR=3.3, CI (95%)=1.105-10.221, p=0.028]. On the other hand, age below 40 years old [OR: 0.122, CI (95%)=0.015-0.981, p=0.022] was identified as a protective factor. Conclusion: the PLHIV under study have multi-factorial exposure associated with chronic kidney disease. However, knowing these factors helps to identify the existing risks and/or renal dysfunction, in addition to supporting the clinical decision of the health professionals who directly assist them.

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Section: Discussionsupporting

confidence: 89%

“…Among the non-modifiable associated factors for developing CKD, advanced age is considered an independent marker of decline in renal function in PLHIV by several scholars ( 18 , 27 - 28 , 38 - 39 ) . The same is also identified in this study, in which the cases have a mean age of 61.4 years old and, in the controls, 49.9 years old.…”

Section: Discussionmentioning

confidence: 99%

Factors associated to chronic kidney disease in people living with HIV/AIDS

Pontes

Netto

Kusumota

et al. 2020

Rev. Latino-Am. Enfermagem

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“…Mocroft et al (2007), in a cohort of HIV-positive individuals from 31 countries in Europe, Israel and Argentina found a prevalence of 4.5%. In this study, the overall prevalence of slightly reduced kidney function (stage 2, eGFR 60-89 ml/min/1.73 m 2 ) was 17.0% (n = 16), a rate slightly lower than that found by Cristelli et al (2018), 25% in adult Spanish individuals on ART. However, in our study, a much higher prevalence was found in patients on ART for many years, and the following frequencies were found, according to the study groups: 9.5% in G1, 11.8% in G2, 12.5% in G3 and 43.7% in G4 (Fig.…”

Section: Kidney Diseasescontrasting

confidence: 60%

Contributory role of ART in the development of non-AIDS comorbidities in asymptomatic PLWHA

Tasca¹,

Vidal²,

Manfio³

et al. 2021

JAB

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Background: Despite the many benefits that follow antiretroviral therapy (ART) initiation, its chronic use contributes to the early aging of people living with HIV/AIDS (PLWHA). The aim of this cross-sectional study was to trace the prevalence of and investigate possible renal, bone and metabolic changes, as well as cardiovascular risk in 94 asymptomatic PLWHA, relating them to the duration of ART use. Methods: Four groups were evaluated according to ART use: G1 (n = 21), ART-naïve individuals; G2 (n = 17), <2 years; G3 (n = 40), 2-10 years; and G4 (n = 16) on ART for more than 10 years. Results: Our results showed a high prevalence of dyslipidemic individuals (64%), especially in those under ART. Lower creatine phosphokinase levels were observed in G1 as compared to the others (p < 0.05). Regarding the Framingham score, 12.1% of PLWHA showed moderate and high risk, and the highest proportion (38.5%) occurred in G4 (p = 0.003). A decrease in glomerular filtration rates occurred in 20% of patients, which was also more significant in G3 and G4 (p = 0.007). High prevalences of osteopenia and osteoporosis (53.2%) were found, especially in G1 and G4; however, G1 showed the lowest means for alkaline phosphatases (AP, p = 0.04 and BAP, p = 0.005) and osteocalcin (p = 0.005), in addition to higher vitamin-D concentrations (p = 0.04). Conclusions: Our study showed the possible contributory role of ART in these changes, which leads us to reflect on the need for specific conducts and patient care, pointing out the importance of individualized care in an attempt to increase life expectancy.

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“…A 2018 study of 4337 (19% female) PLWH in Spain found that WLWH were significantly more likely to have mild renal impairment than MLWH (29.2% vs. 23.9%; p = 0.002) [34]. WLWH were older (47 vs. 44 years), more likely to be black (5.3% vs. 1.4%), had a higher prevalence of HCV coinfection (32.8% vs. 19.4%), had lived with HIV for longer (17.5 vs. 9.2 years) and had a prior AIDS diagnosis.…”

Section: Resultsmentioning

confidence: 99%

Comorbidities in women living with HIV: A systematic review

2022

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Objectives Effective antiretroviral therapy (ART) has improved the life expectancy of women living with HIV (WLWH). This population is now experiencing age‐related comorbidities. This systematic review presents the current understanding of the prevalence and impact of comorbidities in WLWH in the modern ART era. Methods MEDLINE and Embase were searched for studies (1 January 2010 to 1 September 2020) reporting the prevalence of cardiovascular, bone, renal and neurocognitive disease in WLWH aged > 18 years. Studies were included if at least 100 participants (or > 50%) were female and data analysis included prevalence by sex. Results In all, 3050 articles were identified and screened; 153 full‐text articles were assessed for eligibility and 38 were included in the final review. Significant gaps in the literature were identified, notably a lack of data on WLWH aged > 50 years. The data suggest a high burden of cardiovascular, bone, renal and neurocognitive disease in WLWH compared with HIV negative women. Traditional risk factors, such as hypertension, diabetes and dyslipidaemia, were common and often poorly managed. Generalizability of the results was limited, as many studies were conducted in the USA. Comparisons between WLWH and men with HIV were limited by marked differences in demographic and socioeconomic factors. Conclusions Women living with HIV experience a high burden of comorbid disease. Traditional risk factors are common and often poorly managed. This review also highlights the magnitude of differences between women and men living with HIV beyond the pathophysiological. Future research must unpick the complex drivers of morbidity in WLWH, to improve the holistic management of this population.

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Prevalence and risk factors of mild chronic renal failure in HIV-infected patients: influence of female gender and antiretroviral therapy

Cited by 14 publications

References 49 publications

Factors associated to chronic kidney disease in people living with HIV/AIDS

Factors associated to chronic kidney disease in people living with HIV/AIDS

Contributory role of ART in the development of non-AIDS comorbidities in asymptomatic PLWHA

Comorbidities in women living with HIV: A systematic review

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