Racial Differences in End-Stage Renal Disease Rates in HIV Infection versus Diabetes

Abstract

Few studies have compared the incidence of end-stage renal disease (ESRD) among individuals with the human immunodeficiency virus (HIV) and diabetes. We followed a national sample of 2,015,891 US veterans over a median peroid of 3.7 years for progression to ESRD. The age-and sex-adjusted incidence of ESRD (per 1000 person-years) among HIV-infected black patients was nearly an order of magnitude higher than among HIV-positive white patients, almost twice that of diabetic whites, and similar to that among diabetic blacks. In multivariate Cox proportional hazards analysis, diabetes was associated with an increased risk of ESRD among white patients, but HIV was not. Among black individuals, however, both HIV and diabetes conferred a similar increase in the risk of ESRD (4-to 5-fold increase compared to white individuals without HIV or diabetes). HIV and diabetes carry a similar risk of ESRD among black patients, highlighting the importance of developing strategies to prevent and treat renal disease among HIV-infected black individuals.

Prevalence of Chronic Kidney Failure and Associated Factors in Patients Treated by Antiretroviral in the National Teaching Hospital of Cotonou

“…Diabetes is already a traditional risk factor for chronic kidney disease in the general population. Several studies had demonstrated that diabetes plays an important role in kidney disease in the HIV infected patients [3,10,20]. Krawczyk et al in the United States (p=0.259) and Flandre et al in France (p=0.30) did not find an association between diabetes and chronic kidney failure among HIV infected patients [4,18].…”

“…Emem studying kidney disease defined by the presence of proteinuria positive dipstick and/or serum creatinine higher than or equal to 132 μmol/L (15 mg/L) in seropositive-HIV patients in Nigeria had found a prevalence of 38% [9]. Similarly, in Uganda, Andia had found a prevalence of chronic kidney disease to 48.5% in Patients with HIV [10].…”

Cystatin C: current position and future prospects

“…A prevalence of CRF in different populations of HIV-infected people (whether or not treated, controlled or otherwise) may be as high as 5% to 25% (188)(189)(190). Highly active anti-retroviral therapy (HAART) treatment has not eliminated HIV-specific renal disease, the HIV-associated nephropathy (HIVAN), which is responsible for 40% to 60% of the histological renal disease (191), or the need for transplantation in HIV-infected patients (192).…”

Epidemiological, clinical, and laboratory factors associated with chronic kidney disease in Mexican HIV-infected patients

“…1 The reported prevalence of CKD in patients infected with HIV in North America and Europe ranges from 4.7% to 9.7%, and higher rates have been reported when CKD is defined by either estimated glomerular filtration rate (eGFR) or proteinuria. [2][3][4] HIV infection is a well-established risk factor for CKD and endstage renal disease (ESRD).…”