Risk of End-Stage Renal Disease in HIV-Positive Potential Live Kidney Donors.

Autor: Muzaale AD; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD., Althoff KN; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD., Sperati CJ; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD., Abraham AG; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD., Kucirka LM; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD., Massie AB; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD., Kitahata MM; University of Washington Center for AIDS Research, Seattle, WA., Horberg MA; Mid-Atlantic Permanente Institute, Rockville, MD., Justice AC; Veterans Affairs Connecticut Healthcare System, West Haven, CT., Fischer MJ; Jesse Brown VA Medical Center and Hines VA Hospital, Chicago, IL., Silverberg MJ; Kaiser Permanente Division of Research, Oakland, CA., Butt AA; Hamad Healthcare Quality Institute, Hamad Medical Corporation, Doha, Qatar.; Weill Cornell Medical College, Doha, Qatar.; Weill Cornell Medical College, New York, NY., Boswell SL; Fenway Health HIV Cohort, Boston, MA., Rachlis AR; Infectious Diseases Division, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada., Mayor AM; Universidad Central del Caribe, Bayamón, PR., Gill MJ; Southern Alberta HIV Clinic, Sheldon M. Chumir Health Centre, Calgary, Alberta, Canada., Eron JJ; University of North Carolina, HIV Clinic Cohort, Chapel Hill, NC., Napravnik S; University of North Carolina, HIV Clinic Cohort, Chapel Hill, NC., Drozd DR; The Polyclinic Madison Center, Seattle, WA., Martin JN; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA., Bosch RJ; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA., Durand CM; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD., Locke JE; Department of Surgery, University of Alabama, Birmingham, AL., Moore RD; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD., Lucas GM; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD., Segev DL; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD.
Jazyk: angličtina
Zdroj: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2017 Jul; Vol. 17 (7), pp. 1823-1832. Date of Electronic Publication: 2017 May 12.
DOI: 10.1111/ajt.14235
Abstrakt: New federal regulations allow HIV-positive individuals to be live kidney donors; however, potential candidacy for donation is poorly understood given the increased risk of end-stage renal disease (ESRD) associated with HIV infection. To better understand this risk, we compared the incidence of ESRD among 41 968 HIV-positive participants of North America AIDS Cohort Collaboration on Research and Design followed for a median of 5 years with the incidence of ESRD among comparable HIV-negative participants of National Health and Nutrition Examination III followed for a median of 14 years. We used risk associations from multivariable Cox proportional hazards regression to derive cumulative incidence estimates for selected HIV-positive scenarios (no history of diabetes, hypertension, AIDS, or hepatitis C virus coinfection) and compared these estimates with those from similarly selected HIV-negative scenarios. For 40-year-old HIV-positive individuals with health characteristics that were similar to those of age-matched kidney donors, viral load <400 copies/mL, and CD4 + count ≥500 cells/μL, the 9-year cumulative incidence of ESRD was higher than that of their HIV-negative peers, yet still low: 2.5 versus 1.1 per 10 000 among white women, 3.0 versus 1.3 per 10 000 among white men, 13.2 versus 3.6 per 10 000 among black women, and 15.8 versus 4.4 per 10 000 among black men. HIV-positive individuals with no comorbidities and well-controlled disease may be considered low-risk kidney donor candidates.
(© 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.)
Databáze: MEDLINE
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