Prevalence and Pattern of Chronic Kidney Disease in Antiretroviral-Naïve Patients with HIV/AIDS

Adedeji, Tewogbade Adeoye; Adedeji, Nife Olamide; Adebisi, SA; Idowu, Ademola A.; Fawale, Bimbo; Jimoh, Ayodele

doi:10.1177/2325957415587570

Cited by 19 publications

(25 citation statements)

References 27 publications

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“…The initial literature search retrieved 1220 articles of which 99 were selected after title and abstract screening for full-text review. Finally, 61 articles [ 23 , 32 – 91 ] were eligible and included in this systematic review ( Fig 1 ). There was a high agreement between investigators for study inclusion (κ = 0.81).…”

Section: Resultsmentioning

confidence: 99%

“…MDRD, CG and CKD-EPI equations were used to estimate GFR in 45 studies (n = 167,011 participants), 19 studies (n = 59,414 participants) and 14 studies (n = 41,791 participants) respectively. Thirty-one studies (n = 111,415 participants) used MDRD [ 32 – 35 , 37 – 45 , 48 , 51 – 54 , 57 , 59 , 62 , 65 – 69 , 82 , 84 , 85 , 89 ] equation only; 7 (n = 16,756 participants) used CKD–EPI [ 76 – 80 , 83 , 86 ] and 9 (n = 24,622 participants) used CG only [ 23 , 70 – 75 , 81 ]. Seven articles (n = 31,268 participants) applied MDRD and CG [ 36 , 50 , 55 , 56 , 60 , 64 , 87 ]; 4 (n = 20,742 participants) applied MDRD and CKD-EPI [ 46 , 47 , 49 , 58 ] while 3 (n = 4,275 participants) applied all 3 equations [ 61 , 63 , 88 ].…”

Section: Resultsmentioning

confidence: 99%

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Chronic kidney disease in the global adult HIV-infected population: A systematic review and meta-analysis

et al. 2018

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IntroductionThe widespread use of antiretroviral therapies (ART) has increased life expectancy in HIV patients, predisposing them to chronic non-communicable diseases including Chronic Kidney Disease (CKD). We performed a systematic review and meta-analysis (PROSPERO registration number CRD42016036246) to determine the global and regional prevalence of CKD in HIV patients.MethodsWe searched PubMed, Web of Science, EBSCO and AJOL for articles published between January 1982 and May 2016. CKD was defined as estimated glomerular filtration rate (eGFR) <60ml/min using the MDRD, Cockcroft-Gault or CKD-EPI equations. Random effects model was used to combine prevalence estimates from across studies after variance stabilization via Freeman–Tukey transformation.ResultSixty-one eligible articles (n = 209,078 HIV patients) in 60 countries were selected. The overall CKD prevalence was 6.4% (95%CI 5.2–7.7%) with MDRD, 4.8% (95%CI 2.9–7.1%) with CKD-EPI and 12.3% (95%CI 8.4–16.7%) with Cockcroft–Gault; p = 0.003 for difference across estimators. Sub-group analysis identified differences in prevalence by WHO region with Africa having the highest MDRD-based prevalence at 7.9% (95%CI 5.2–11.1%). Within Africa, the pooled MDRD-based prevalence was highest in West Africa [14.6% (95%CI 9.9–20.0%)] and lowest in Southern Africa (3.2%, 95%CI 3.0–3.4%). The heterogeneity observed could be explained by WHO region, comorbid hypertension and diabetes mellitus, but not by gender, hepatitis B or C coinfection, CD4 count or antiretroviral status.ConclusionCKD is common in HIV-infected people, particularly in Africa. HIV treatment programs need to intensify screening for CKD with added need to introduce global guidelines for CKD identification and treatment in HIV positive patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Chronic kidney disease in the global adult HIV-infected population: A systematic review and meta-analysis

et al. 2018

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“…Previous studies were conducted on adult HIV patients. Among them are studies by Verma and Singh [22] in India (r = -0.26, P = 0.02) and Adedeji et al [23] in Nigeria (r = -0.228, P = 0.025). The difference in results may be due to differences in subject age, the greater number of subjects in the previous studies, and the various mechanisms possibly underlying kidney complications.…”

Section: Discussionmentioning

confidence: 99%

Correlation between CD4 count and glomerular filtration rate or urine protein:creatinine ratio in human immunodeficiency virus-infected children

Aliyannissa

Kuswiyanto

Setiabudi

et al. 2020

Kidney Res Clin Pract

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Kidney issues are an important complication of human immunodeficiency virus (HIV) infection, with prevalence varying between 5% to 48.5% worldwide [1-3]. Deaths due to kidney diseases account for 12.2% of all HIV patient deaths [4]. In Sub-Saharan Africa, a 67% increase in mortality due to nephritis and nephrosis has been reported from 1999 to 2006 [5]. Not only are patients with HIV infection at greater risk of kidney disease, but they are also more likely to experience faster kidney dysfunction progression compared to individuals without HIV

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“…In this study 29.6 % of patients were diagnosed with stage 2 kidney disease and 1.4 % with stage 3 kidney disease. These numbers are quite high, compared with a prevalence of chronic kidney disease in patients with HIV infection reported at 6 % in the Danish HIV cohort study [9], 24 % in Nigeria [10], and 2 % [11], 10.2 % [12] or 15.5 % [13] in the United States of America.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of osteo-renal impairment in the Romanian HIV cohort

et al. 2016

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Background: The Romanian HIV cohort has certain particularities that render it unique in Europe. We have performed a study to evaluate the prevalence of bone and kidney impairment in this particular group of HIVinfected patients. Methods: We performed dual-energy X-ray absorptiometry (DXA) evaluation of the lumbar vertebrae and the femur, as well as laboratory tests including standard serum panels, bone-related markers and urinalysis in patients from the Romanian HIV cohort. Results: The study included 72 patients, of which 46 (58.3 %) were males. The median (IQR) age was 38 (18) years and the median (IQR) time from HIV infection diagnosis was 9 (13) years. Most patients (55.6 %) were non-smokers, but a relatively high proportion (37.5 %) was currently smoking. Only a small percentage of patients (20.8 %) did not present any comorbidities, while 40.3 % had one comorbidity, the most frequent being dyslipidemia (present in 25 patients, 38.5 %). Only 6 patients had a medical history suggestive for renal disease and 3 for bone-related abnormalities. The median (IQR) glomerular filtration rate was 97.5 (33.0) mL/min/1.73sqm. We diagnosed 21 patients (29.6 %) with stage 2 chronic kidney disease and one patient (1.4 %) with stage 3 chronic kidney disease. Proteinuria was present in 9 (12.7 %) patients. The estimated glomerular filtration rate was significantly lower in patients with cardiac comorbidities (p = 0.013). Vitamin D was significantly lower in smokers compared with non-smokers, with a mean value of 15 vs. 21 ng/mL and a moderate effect size (Cohen's d = −0.5) (p = 0.046). Lumbar osteopenia and osteoporosis were diagnosed in 33.3 and 13.7 % of patients, while femoral osteopenia and osteoporosis were diagnosed in 37.3 and 7.8 %, respectively. Lower nadir CD4 cell counts were found in patients with bone-related comorbidities (p = 0.000). Conclusions: We identified a relatively high prevalence of chronic kidney disease in the Romanian HIV cohort, and a fairly low prevalence of osteopenia and osteoporosis, compared with other European countries. In this category of patients smoking should be avoided altogether, as it may be an indirect risk factor for kidney disease (associating cardiac comorbidities) and it may impair bone metabolism by altering serum levels of hydroxy-vitamin D.

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Prevalence and Pattern of Chronic Kidney Disease in Antiretroviral-Naïve Patients with HIV/AIDS

Abstract: In ART-naive patients, CKD is common, and low eGFR was associated with lower CD4 counts.

Cited by 19 publications

References 27 publications

Chronic kidney disease in the global adult HIV-infected population: A systematic review and meta-analysis

Chronic kidney disease in the global adult HIV-infected population: A systematic review and meta-analysis

Correlation between CD4 count and glomerular filtration rate or urine protein:creatinine ratio in human immunodeficiency virus-infected children

Prevalence of osteo-renal impairment in the Romanian HIV cohort

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