Increased non-HDL-C level linked with a rapid rate of renal function decline in HIV-infected patients

Hara, Masaki; Yanagisawa, Naoki; Ohta, Akihito; Momoki, Kumiko; Tsuchiya, Ken; Nitta, Kosaku; Ando, Minoru

doi:10.1007/s10157-016-1281-9

Cited by 9 publications

(11 citation statements)

References 43 publications

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“…Chronically low HDL levels are associated with progression of CKD in patients with HIV and patients with type 2 diabetes . Similar results were demonstrated in two epidemiological studies that evaluated the risk factors for the development of kidney disease.…”

Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

“…Prior studies postulated that the mechanism through which low HDL levels were associated with decreased renal function was through the coexistent high levels of non‐HDL cholesterol . Increased non‐HDL cholesterol may facilitate intra‐renal arteriosclerosis , microalbuminuria and lipid‐induced glomerular toxicity , precipitating renal dysfunction. In contrast, patients with decreased eGFR from our cohort showed lower levels of non‐HDL (mean ± SD) when compared to patients with no decreased eGFR, although this difference was not statistically significant (74.7 ± 32.6 mg dL −1 vs. 86.7 ± 39.7 mg dL −1 , P = 0.111, data not shown).…”

Section: Discussionmentioning

confidence: 99%

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Two‐year follow‐up of patients with septic shock presenting with low HDL: the effect upon acute kidney injury, death and estimated glomerular filtration rate

Genga

Cirstea

et al. 2017

J Intern Med

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Two‐year follow‐up of patients with septic shock presenting with low HDL: the effect upon acute kidney injury, death and estimated glomerular filtration rate

Genga

Cirstea

et al. 2017

J Intern Med

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“…It has been reported that the prevalence of chronic kidney disease in HIV-positive patients in Japan is 15.4% [7]. Hara et al reported that chronic kidney disease in HIV-positive patients progresses more rapidly than that in non-HIV patients [8]. Rasch et al reported that the introduction rate of hemodialysis in HIV positive patients is 3.6 times higher than that of non-HIV patients [9].…”

Section: Discussionmentioning

confidence: 99%

Acceptance situation of HIV patients in Japanese dialysis facilities—questionnaire survey by the Infection Survey Subcommittee

et al. 2018

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Background: A newspaper article in August 2016 reported that about 40 medical facilities refused dialysis to a human immunodeficiency virus (HIV) patient. Infection Survey Subcommittee in the Japanese Society for Dialysis Therapy investigated this situation. Methods: An anonymous questionnaire survey about the acceptance of HIV-positive patients was sent to 4039 dialysis institutions. The questionnaire included a number of HIV-positive patients on dialysis currently and in the last 5 years, details on whether the institution received requests to perform dialysis on HIV-positive patients, the responses to these requests, the preparation system for acceptance, the reasons for refusal of dialysis of HIV-positive patients, knowledge of HIV-related guidelines in use, and the considerations for the acceptance of dialysis for HIV-positive patients. We evaluated answers to these questions from the institutions. Results: Two thousand five hundred eighty-three facilities (64.0%) responded to the survey questions. In the past 5 years, 215 facilities (8.3%) were requested to accept HIV patients for dialysis and 40.1% of these refused acceptance. Although manuals, written policy and procedure, for a needle piercing accident existed in most of the facilities that accepted the patients, many facilities did neither prepare the stocks of anti-HIV drugs nor cooperate with HIV core hospitals. Principal reasons for the refusal were listed as the lack of medical experience with HIV patients, anxiety of healthcare providers with regard to HIV infection risk, lack of stocks of anti-HIV drugs for needle piercing accidents, and the lack of cooperation with HIV core hospitals. The proportion of facilities expected to accept HIV patients in the future was as low as 16.9% among all facilities that responded to the survey. Conclusions: The Japanese Society for Dialysis Therapy will need to strengthen the cooperation with other academic societies and disseminate basic knowledge on HIV and infection control measures to develop and establish the acceptance system of maintenance dialysis for HIV patients.

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“…A rapid annual reduction in eGFR in HIV-infected patients Kooij et al showed that being HIV-infected was independently associated with greater eGFR decline (− 1.59 [95% CI, − 0.87 to − 0.24] mL/min/1.73 m 2 /year in HIVinfected patients vs. − 0.69 [95% CI, − 0.91 to − 0.48] mL/min/1.73 m 2 /year in HIV-uninfected individuals; P = 0.001) among 479 HIV-infected and 377 HIV-uninfected individuals (median follow-up 3.9 and 4.1 years, respectively) [35]. In Japan, Hara et al longitudinally studied the rate of change in eGFR in 509 HIV-infected patients (598 males and 63 females, mean age 46.4 years) [36]. During the 6 years from 2008 to 2014, eGFR decreased at a mean annual rate of 2.01 mL/min/1.73 m 2 .…”

Section: Characteristics Of Ckd In Hiv-infected Patients In Japanmentioning

confidence: 99%

A high likelihood of increase in end-stage renal disease among the Japanese HIV-infected population

Ando¹,

Ando²

2019

Ren Replace Ther

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Kidneys are affected by human immunodeficiency virus (HIV) infection and its associated therapies. Antiretroviral therapy (ART) has markedly reduced acquired immune deficiency syndrome-related deaths and opportunistic infectious diseases among HIV-infected patients. This contributed to their prolonged survival; however, the improvement in survival has been accompanied by an increase in the incidence of non-infectious chronic complications, including hypertension, metabolic diseases, and chronic kidney disease (CKD). Recent studies showed that estimated prevalence of any CKD and end-stage renal disease (ESRD) among HIV-infected patients is approximately 20% and 0.5%, respectively, in Japan. Both a rapid decrease in renal function and a high positive rate of albuminuria and proteinuria are clinical characteristics of HIV-infected patients. Moreover, considering higher complication rates of hypertension and diabetes compared with non-HIV-infected individuals of the similar aging, HIV-infected patients who develop CKD and ESRD are very likely to increase. Furthermore, as the survival rate is favorable after the initiation of dialysis, the cumulative number of ESRD patients is supposed to increase. The corporation for treatment of HIV-positive hemodialysis patients by general dialysis clinics will be urgently required; however, there still remain some preoccupations and prejudices about HIV per se in Japan, which may provoke hesitation from accepting those patients.

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Increased non-HDL-C level linked with a rapid rate of renal function decline in HIV-infected patients

Abstract: Increased non-HDL-C levels are a risk factor for renal function decline in HIV-infected patients.

Cited by 9 publications

References 43 publications

Two‐year follow‐up of patients with septic shock presenting with low HDL: the effect upon acute kidney injury, death and estimated glomerular filtration rate

Two‐year follow‐up of patients with septic shock presenting with low HDL: the effect upon acute kidney injury, death and estimated glomerular filtration rate

Acceptance situation of HIV patients in Japanese dialysis facilities—questionnaire survey by the Infection Survey Subcommittee

A high likelihood of increase in end-stage renal disease among the Japanese HIV-infected population

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