Evaluation of the Prognostic Value of Impaired Renal Function on Clinical Progression in a Large Cohort of HIV-Infected People Seen for Care in Italy | Zendy

Alessandra Bandera | Zendy; Andrea Gori | Zendy; Francesca Sabbatini | Zendy; Giordano Madeddu | Zendy; Stefano Bonora | Zendy; Raffaella Libertone | Zendy; Claudio Maria Mastroianni | Zendy; Paolo Bonfanti | Zendy; Antonella d’Arminio Monforte | Zendy; Alessandro CozziLepri | Zendy

Open Access

Evaluation of the Prognostic Value of Impaired Renal Function on Clinical Progression in a Large Cohort of HIV-Infected People Seen for Care in Italy

Author(s) -

Alessandra Bandera,

Andrea Gori,

Francesca Sabbatini,

Giordano Madeddu,

Stefano Bonora,

Raffaella Libertone,

Claudio Maria Mastroianni,

Paolo Bonfanti,

Antonella d’Arminio Monforte,

Alessandro CozziLepri

Publication year - 2015

Publication title -

plos one

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.99

H-Index - 332

ISSN - 1932-6203

DOI - 10.1371/journal.pone.0124252

Subject(s) - medicine , renal function , quartile , proportional hazards model , cohort , population , kidney disease , survival analysis , hazard ratio , cohort study , confidence interval , environmental health

Whilst renal dysfunction, especially mild impairment (6090, 60-89, <60 ml/min, was 2.91 (95% CI 2.30-3.67), 4.63 (95% CI 3.51-6.11) and 11.9 (95% CI 6.19-22.85) per 1,000 PYFU respectively, with an unadjusted hazard ratio (HR) of 4.14 (95%CI 2.07-8.29) for patients with eGFR <60 ml/min and 1.58 (95%CI 1.10-2.27) for eGFR 60-89 compared to those with eGFR ≥90. Of note, these estimates are adjusted for traditional cardio-vascular risk factors (e.g. smoking, diabetes, hypertension, dyslipidemia). Incidence of AIDS-related events was 9.51 (95%CI 8.35-10.83), 6.04 (95%CI 4.74-7.71) and 25.0 (95%CI 15.96-39.22) per 1,000 PYFU, among patients with eGFR >90, 60-89, <60 ml/min, respectively, with an unadjusted HR of 2.49 (95%CI 1.56-3.97) for patients with eGFR <60 ml/min and 0.68 (95%CI 0.52-0.90) for eGFR 60-89. The risk of AIDS events was significantly lower in mild renal dysfunction group even after adjustment for HIV-related characteristics. Our data confirm that impaired renal function is an important risk marker for CCVD events in the HIV-population; importantly, even those with mild renal impairment (90

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