Acute kidney injury in patients with human immunodeficiency virus infection

Cohen, Scott; Chawla, Lakhmir S.; Kimmel, Paul L.

doi:10.1097/mcc.0b013e3283186f43

Cited by 37 publications

(28 citation statements)

References 95 publications

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“…Males have consistently predominated in reports on the incidence of AKI as a complication in infections, such as HIV 6,7 , leptospirosis 8 and other community-acquired AKI. The reasons for such gender differences are unclear but are likely associated with work activities.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury in a tropical country: a cohort study of 253 patients in an infectious diseases intensive care unit

Daher

Silva

Vieira

et al. 2014

Rev. Soc. Bras. Med. Trop.

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introduction:Acute kidney injury (AKI) is a frequent and potentially fatal complication in infectious diseases. The aim of this study was to investigate the clinical aspects of AKI associated with infectious diseases and the factors associated with mortality. Methods: This retrospective study was conducted in patients with AKI who were admitted to the intensive care unit (ICU) of a tertiary infectious diseases hospital from January 2003 to January 2012. The major underlying diseases and clinical and laboratory fi ndings were evaluated. Results: A total of 253 cases were included. The mean age was 46±16 years, and 72% of the patients were male. The main diseases were human immunodefi ciency virus (HIV) infection, HIV/acquired immunodefi ciency syndrome (AIDS) (30%), tuberculosis (12%), leptospirosis (11%) and dengue (4%). Dialysis was performed in 70 cases (27.6%). The patients were classifi ed as risk (4.4%), injury (63.6%) or failure (32%). The time between AKI diagnosis and dialysis was 3.6±4.7 days. Oliguria was observed in 112 cases (45.7%). The Acute Physiology and Chronic Health Evaluation (APACHE) II scores were higher in patients with HIV/AIDS (57±20, p-value=0.01) and dengue (68±11, p-value=0.01). Death occurred in 159 cases (62.8%). Mortality was higher in patients with HIV/AIDS (76.6%, p-value=0.02). A multivariate analysis identifi ed the following independent risk factors for death: oliguria, metabolic acidosis, sepsis, hypovolemia, the need for vasoactive drugs, the need for mechanical ventilation and the APACHE II score. Conclusions: AKI is a common complication in infectious diseases, with high mortality. Mortality was higher in patients with HIV/AIDS, most likely due to the severity of immunosuppression and opportunistic diseases.

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Section: Discussionmentioning

confidence: 99%

Acute kidney injury in a tropical country: a cohort study of 253 patients in an infectious diseases intensive care unit

Daher

Silva

Vieira

et al. 2014

Rev. Soc. Bras. Med. Trop.

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“…HAART itself can be associated with acute kidney injury and progressive nephropathy [3,4,55,56,57,58]. Some patients with normal kidney function at baseline still progress to CKD stage ≥3 despite HAART, as documented in 1.9 and 1.6% of the patients participating in ALLRT and DART studies, respectively [28,59].…”

Section: Limitationsmentioning

confidence: 99%

Treatment of HIV-Associated Nephropathies

Elewa

Sandri

Rizza³

et al. 2011

Nephron Clin Pract

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In patients with HIV, the use of highly active antiretroviral therapy has improved life expectancy. At the same time, this increase in life expectancy has been associated with a higher frequency of chronic kidney disease due to factors other than HIV infection. Besides HIV-associated nephropathy, a number of different types of immune complex and non-immune complex-mediated processes have been identified on kidney biopsies, including vascular disease (nephrosclerosis), diabetes, and drug-related renal injury. In this setting, renal biopsy needs to be considered in order to obtain the correct diagnosis in individual patients with HIV and kidney impairment. Many issues regarding the optimal treatment of the different pathological processes affecting the kidneys of these patients have remained unresolved. Further research is needed in order to optimize treatment and renal outcomes in patients with HIV and kidney disease.

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“…HIV-infected patients are at higher risk to develop AKI, and the possible risk factors are elevated viral load, low CD4 count, co-infection with hepatitis C, diabetes, black race, male gender, and chronic kidney disease (13).…”

Section: Discussionmentioning

confidence: 99%