HIV Care and the Incidence of Acute Renal Failure

Roe, Jennifer; Campbell, Lucy; Ibrahim, Fowzia; Hendry, Bruce M.; Post, Frank A.

doi:10.1086/589296

Cited by 78 publications

(98 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Tenofovir and indinavir have been shown to be related to nephrotoxicity in many studies (2,5,6,10,11,25). Some factors (hepatitis B or C and diabetes) traditionally reported as related to CKD in persons with or without HIV-1 infection were not found to be independently associated with the occurrence of CKD in our analysis (5,26,27).…”

Section: Discussionmentioning

confidence: 50%

Risk Factors of Chronic Kidney Disease in HIV-infected Patients

Flandre¹,

Puglièse²,

Cuzin³

et al. 2011

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryBackground and objectives The main aim of this study was determining the risk factors of chronic kidney disease (CKD) in HIV-1-infected patients.Design, setting, participants, & measurements Patients were followed from seven large HIV reference centers in France that maintain prospective databases on HIV-1-infected patients. The main outcome was the time to CKD defined as two consecutive measures of estimated GFR Յ60 ml/min per 1.73 m 2 over Ն3 months. A Cox's model with delayed entry was used to search predictive factors of time to CKD.Results From 1993 to 2006, 349 out of 7378 patients were found to have CKD. Of these, 166 had hypertension, 33 had diabetes, and 26 were antiretroviral therapy-naïve. Occurrence of acute kidney injury (hazard ratio [HR] ϭ 2.40) and hypertension (HR ϭ 2.39) were strongly associated with an increased risk of CKD. Patients with a durable level of CD4 count Ͼ200 cells/mm 3 had a lower risk of CKD (HR ϭ 0.63). Recent exposure to indinavir (HR ϭ 2.03), totenofovir (HR ϭ 1.55), and abacavir (HR ϭ 1.37) were associated with an increased risk of CKD. Past exposure to tenofovir was also associated with an increased risk of CKD (HR ϭ 2.23), and a trend toward significance was observed for past exposure to indinavir (HR ϭ 1.28).Conclusions CKD was not rare in HIV-infected patients and occurs preferentially in HIV-infected patients exposed to certain ARVs, specifically abacavir, indinavir and tenofovir. This requires closer monitoring of renal function in patients exposed to one of these drugs.

show abstract

Section: Discussionmentioning

confidence: 50%

Risk Factors of Chronic Kidney Disease in HIV-infected Patients

Flandre¹,

Puglièse²,

Cuzin³

et al. 2011

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…1 Recent epidemiologic studies have revealed that coinfection with hepatitis C virus (HCV) confers an even greater risk of both acute kidney injury (AKI) and chronic kidney (CKD) disease among individuals infected with HIV. [3][4][5][6][7] AKI is a common complication among both ambulatory and hospitalized HIV-infected patients in the highly active antiretroviral therapy (HAART) era. 3,4 In one study involving hospitalized HIV patients by Wyatt and colleagues, 3 AKI was associated with a 5.83 increased odds of in-hospital mortality.…”

mentioning

confidence: 99%

“…A subsequent study in the United Kingdom demonstrated that among 20 HIV/HCVcoinfected patients with AKI, 7 had advanced cirrhosis while 5 experienced infectious complications of injection drug use (IDU). 7 Although decompensated liver cirrhosis and infectious complications of IDU underlie some of the etiologies by which HIV/HCV coinfected patients develop AKI, additional mechanisms remain unexplored. HCV has independently been associated with immune complex-mediated renal injury, but epidemiologic studies of the association between HCV monoinfection and renal disease have been inconclusive.…”

mentioning

confidence: 99%

Incidence and Predictors of Acute Kidney Injury in an Urban Cohort of Subjects with HIV and Hepatitis C Virus Coinfection

Garg

Hoenig

Edwards

et al. 2011

AIDS Patient Care and STDs

View full text Add to dashboard Cite

Coinfection with hepatitis C (HCV) significantly increases the risk of acute and chronic renal disease in HIVinfected individuals. However, the burden of acute kidney injury (AKI) directly attributable to HIV among HCV-infected individuals and associated risk factors are not well understood. Within a prospective cohort, AKI episodes were identified by a rise in creatinine of 0.5 mg/dL. Incidence of first AKI events was calculated for HIV/HCV coinfected versus HCV monoinfected subjects, and multivariable analyses using Cox proportional hazards were performed to identify predictors of AKI. Throughout the study period, 35% HIV/HCV coinfected and 17% HCV monoinfected subjects developed AKI, with incidence of 8. (HR 2.06 [1.15, 3.71]) were independently associated with AKI. HCV genotype, HCV viral load, hazardous drinking, and heroin use were not associated with AKI. Study limitations included potential misclassification bias of HCV-infected individuals as serial HIV antibody testing was not routinely performed after study entry, and inability to adjust for tenofovir use in multivariable analysis. In conclusion, among subjects with HCV infection, decompensated cirrhosis, HIV coinfection, and cocaine use are associated with increased risk of AKI. These findings highlight the importance of preventing and treating cirrhosis, controlling HIV coinfection, and reducing cocaine use in HIV/HCV coinfected persons.

show abstract

“…7 Kidney disease and subsequent renal failure is the fourth leading cause of death in HIV-positive patients. 8 Renal dysfunction in patients with HIV can be caused by nephrotoxic medications such as antibiotics and antifungals, metabolic dysfunction and volume depletion as a result of chronic diarrhea, ureteral obstruction from malignancy, infections, and intrinsic diseases such as HIV-associated nephropathy (HIVAN), which occurs in 10-30% of patients with HIV.…”

Section: Renal Dysfunctionmentioning

confidence: 99%