Dataset Information

Baseline kidney function as predictor of mortality and kidney disease progression in HIV-positive patients.

ABSTRACT:

Background

Chronic kidney disease (CKD) is associated with increased all-cause mortality and kidney disease progression. Decreased kidney function at baseline may identify human immunodeficiency virus (HIV)-positive patients at increased risk of death and kidney disease progression.

Study design

Observational cohort study.

Setting & participants

7 large HIV cohorts in the United Kingdom with kidney function data available for 20,132 patients.

Predictor

Baseline estimated glomerular filtration rate (eGFR).

Outcomes

Death and progression to stages 4-5 CKD (eGFR <30 mL/min/1.73 m(2) for >3 months) in Cox proportional hazards and competing-risk regression models.

Results

Median age at baseline was 34 (25th-75th percentile, 30-40) years, median CD4 cell count was 350 (25th-75th percentile, 208-520) cells/?L, and median eGFR was 100 (25th-75th percentile, 87-112) mL/min/1.73 m(2). Patients were followed up for a median of 5.3 (25th-75th percentile, 2.0-8.9) years, during which 1,820 died and 56 progressed to stages 4-5 CKD. A U-shaped relationship between baseline eGFR and mortality was observed. After adjustment for potential confounders, eGFRs <45 and >105 mL/min/1.73 m(2) remained associated significantly with increased risk of death. Baseline eGFR <90 mL/min/1.73 m(2) was associated with increased risk of kidney disease progression, with the highest incidence rates of stages 4-5 CKD (>3 events/100 person-years) observed in black patients with eGFR of 30-59 mL/min/1.73 m(2) and those of white/other ethnicity with eGFR of 30-44 mL/min/1.73 m(2).

Limitations

The relatively small numbers of patients with decreased eGFR at baseline and low rates of progression to stages 4-5 CKD and lack of data for diabetes, hypertension, and proteinuria.

Conclusions

Although stages 4-5 CKD were uncommon in this cohort, baseline eGFR allowed the identification of patients at increased risk of death and at greatest risk of kidney disease progression.

SUBMITTER: Ibrahim F

PROVIDER: S-EPMC3657190 | biostudies-literature | 2012 Oct

REPOSITORIES: biostudies-literature

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Publications

Baseline kidney function as predictor of mortality and kidney disease progression in HIV-positive patients.

Ibrahim Fowzia F Hamzah Lisa L Jones Rachael R Nitsch Dorothea D Sabin Caroline C Post Frank A FA

American journal of kidney diseases : the official journal of the National Kidney Foundation 20120421 4

<h4>Background</h4>Chronic kidney disease (CKD) is associated with increased all-cause mortality and kidney disease progression. Decreased kidney function at baseline may identify human immunodeficiency virus (HIV)-positive patients at increased risk of death and kidney disease progression.<h4>Study design</h4>Observational cohort study.<h4>Setting & participants</h4>7 large HIV cohorts in the United Kingdom with kidney function data available for 20,132 patients.<h4>Predictor</h4>Baseline estim ...[more]

PMID: 22521282

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Dataset Information

Baseline kidney function as predictor of mortality and kidney disease progression in HIV-positive patients.

Background

Study design

Setting & participants

Predictor

Outcomes

Results

Limitations

Conclusions

Publications

Baseline kidney function as predictor of mortality and kidney disease progression in HIV-positive patients.

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