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Clinical Characteristics and Outcomes of Chronic Kidney Disease in People Living with HIV in a Resource-Limited Center of Central China
AIDS Research and Human Retroviruses ( IF 1.5 ) Pub Date : 2022-09-12 , DOI: 10.1089/aid.2022.0009
Ling Feng 1, 2 , Tie-Long Chen 1 , Juan Zhang 3 , Qian Wang 4 , Jie Liu 1 , Xi-En Gui 1, 2 , Jean-Pierre Routy 5 , Qian Cao 1
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Clinical management and optimal treatment are essential to improving outcomes for people living with HIV (PLWH). We assessed trends and outcomes of chronic kidney disease (CKD) in PLWH in a resource-limited center of central China. All PLWH who were followed up in a tertiary referral center in Wuhan, China, from July 2016 to June 2021 were evaluated. CKD was defined as glomerular filtration rate (GFR) <60 mL/min/1.73 m2 during two consecutive measurements 3 months apart. Baseline characteristics of the participants were extracted from the hospital medical records. The prevalence rate and associated risk factors of CKD were analyzed. A total of 863 PLWH with normal kidney function at baseline were analyzed. The median age was 33 (interquartile ranges: 26–49) years, and 778 (90.2%) were male and 85 (9.8%) were female. Among them, 50 (5.8%) had their GFR falling below 60 mL/min/1.73 m2 after a median of 54 months. Adjusted multivariate logistic regression revealed older age [adjusted odds ratio (aOR) = 1.04, 95% confidence interval (95% CI): 1.01–1.07], female sex (aOR = 3.17, 95% CI: 1.14–8.84), lower body weight (aOR = 0.95, 95% CI: 0.91–1.00), lower hemoglobin (aOR = 3.54, 95% CI: 1.51–8.30), longer duration of antiretroviral therapy exposure (aOR = 1.02, 95% CI: 1.00–1.04), and a baseline GFR between 60 and 90 mL/min/1.73 m2 (aOR = 3.89, 95% CI: 1.21–12.46) were associated with the development of CKD. Our findings showed that CKD is not infrequent in PLWH with a combination of traditional and HIV-specific risk factors for kidney disease, highlighting the suboptimal monitoring and treatment options of CKD in PLWH in resource-limited settings. Scalable monitoring strategy to improve care for this population is warranted.
更新日期:2022-09-14
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