Incidence and etiology of acute renal failure among ambulatory HIV-infected patients

Abstract

ARF is common in ambulatory HIV patients. Immunosuppression, infection, and HCV are important conditions associated with ARF in the post-HAART era.

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

“…As no standard definition for AKI exists, a traditional definition of AKI, which has been shown to affect mortality in hospitalized patients without HIV or HCV, was utilized. 4 Recently, smaller changes in serum Cr have been found to be of clinical import, such that a rise in Cr of 0.5 mg/dL is utilized in the RIFLE criteria (Risk Injury Failure Loss End Stage) and a rise of only 0.3 mg/dL is utilized in the AKIN criteria (Acute Kidney Injury Network). 28 In our study, we chose to utilize the more conservative definition of AKI to capture the most serious events.…”

“…For those with baseline Cr greater than 5 mg/dL, AKI was defined as a rise in Cr of 1.5 mg/dL or more, as described previously. 1,4 When a rise in serum Cr occurred, available clinical data were reviewed to determine the probable cause. Events were categorized as prerenal, intrinsic renal, obstructive, or unknown.…”

“…10 AKI is a frequent complication of decompensated cirrhosis in the general population, and in Franceschini's study, 4 liver failure accounted for 18% of AKI events among HIV/HCV-coinfected subjects. 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).…”

“…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.…”

“…[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. Franceschini and colleagues 5 examined predictors of AKI among HIV-infected patients and found that coinfection with HCV was significantly associated with AKI, along with male gender, CD4 count less than 200 cells/mm 3 , HIV viral load (VL) greater than 10,000 copies per milliliter, and HAART exposure.…”