Premium
Prevalence and factors associated with renal impairment in HIV‐infected patients, ANRS C03 Aquitaine Cohort, France
Author(s) -
Déti EK,
Thiébaut R,
Bonnet F,
LawsonAyayi S,
Dupon M,
Neau D,
Pellegrin JL,
Malvy D,
Tchamgoué S,
Dabis F,
Morlat P
Publication year - 2010
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2009.00780.x
Subject(s) - medicine , cohort , body mass index , logistic regression , creatinine , human immunodeficiency virus (hiv) , renal function , odds ratio , gastroenterology , immunology
Objectives The aims of the present study were to estimate the prevalence of renal impairment (RI) among HIV‐infected adult patients and to investigate the associated factors. Methods A cross‐sectional survey was conducted in a French hospital‐based cohort. Clearance of creatinine (CC) was calculated using the Cockcroft–Gault formula. Four stages of RI were defined: mild (60–90 mL/min), moderate (30–60), severe (15–30) and end stage (<15). Logistic regression models were used to investigate factors associated with RI. Results The male/female ratio of the 2588 patients enrolled was 3:1 and the median age was 42 years. At the time of assessment of CC, the median CD4 count was 430 cells/μL and HIV plasma viral load (VL) was<50 copies/mL in 60%. The overall prevalence of RI was 39.0%: 34.2% mild, 4.4% moderate, 0.3% severe and 0.2% end‐stage. Mild RI was associated with female gender [odds ratio (OR)=3.3: 95% CI 2.6–4.3)], age >50 years (OR=9.8: 7.4–13.0) and 40–50 years (OR=1.9: 1.5–2.4), body mass index (BMI) <22 kg/m 2 (OR=3.3: 2.7–4.3) and tenofovir exposure (OR=1.4: 1.0–1.9 for <1 year and OR=1.5: 1.2–2.0 for >1 year). Advanced RI (CC <60 mL/min) was associated with age >50 years (OR=5.6: 2.9–10.9) and 40–50 years (OR=2.2: 1.1–1.4), BMI <22 kg/m 2 (OR=1.5: 1.0–2.4), hypertension (OR=2.5: 1.4–2.5) and indinavir (IDV) exposure >1 year (OR=2.3: 1.5–3.6). Conclusion This survey confirms the high prevalence of RI in HIV‐infected patients and indicates the importance of the investigation of renal function especially in women, older patients, those with a low BMI or treated with tenofovir or IDV.