Prevalence of tubulopathy and association with renal function loss in HIV-infected patients.

Autor:	Lescure FX; Department of Infectious and Tropical Diseases, Bichat Hospital, AP-HP, Paris, France.; Department of Infectious and Tropical Diseases, Tenon Hospital, AP-HP, Paris, France.; Inserm, IAME, UMRS 1137, Paris, France.; Paris Diderot University, Sorbonne Paris Cité, Paris, France., Fellahi S; Department of Biochemistry and Hormonology, Tenon Hospital, AP-HP, Paris, France.; Inserm UMR, Centre de Recherche Saint-Antoine, UMRS 938, Paris, France.; Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne University, UPMC, Paris, France.; Sorbonne Universités, Paris, France., Pialoux G; Department of Infectious and Tropical Diseases, Tenon Hospital, AP-HP, Paris, France.; Inserm, IAME, UMRS 1137, Paris, France.; Paris Diderot University, Sorbonne Paris Cité, Paris, France.; Department of Biochemistry and Hormonology, Tenon Hospital, AP-HP, Paris, France.; Inserm UMR, Centre de Recherche Saint-Antoine, UMRS 938, Paris, France.; Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne University, UPMC, Paris, France.; Sorbonne Universités, Paris, France., Bastard JP; Department of Biochemistry and Hormonology, Tenon Hospital, AP-HP, Paris, France.; Inserm UMR, Centre de Recherche Saint-Antoine, UMRS 938, Paris, France.; Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne University, UPMC, Paris, France.; Sorbonne Universités, Paris, France., Eme AL; Department of Infectious and Tropical Diseases, Bichat Hospital, AP-HP, Paris, France., Esteve E; Department of Nephrology and Dialysis, Tenon Hospital, AP-HP, Paris, France., Lebrette MG; Department of Infectious and Tropical Diseases, Tenon Hospital, AP-HP, Paris, France., Guiard-Schmid JB; Department of Infectious and Tropical Diseases, Tenon Hospital, AP-HP, Paris, France., Capeau J; Department of Biochemistry and Hormonology, Tenon Hospital, AP-HP, Paris, France.; Inserm UMR, Centre de Recherche Saint-Antoine, UMRS 938, Paris, France.; Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne University, UPMC, Paris, France.; Sorbonne Universités, Paris, France., Ronco P; Sorbonne Universités, Paris, France.; Department of Nephrology and Dialysis, Tenon Hospital, AP-HP, Paris, France.; Inserm, UMRS 1155, Paris, France., Costagliola D; Sorbonne Universités, Paris, France.; INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique, IPLESP, Paris, France., Plaisier E; Sorbonne Universités, Paris, France.; Department of Nephrology and Dialysis, Tenon Hospital, AP-HP, Paris, France.; Inserm, UMRS 1155, Paris, France.
Jazyk:	angličtina
Zdroj:	Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2020 Apr 01; Vol. 35 (4), pp. 607-615.
DOI:	10.1093/ndt/gfz081
Abstrakt:	Background: The incidence of chronic kidney disease (CKD) is 10 times higher in human immunodeficiency virus (HIV)-infected patients than in the general population. We explored the prevalence and determinants of proximal tubular dysfunction (PTD) in HIV-infected individuals, and assessed the impact of the tubulopathy on the estimated glomerular filtration rate (eGFR) outcome. Methods: A cohort study was performed on 694 outpatients followed in a French centre to analyse the prevalence of PTD, the diagnosis performance of screening tools and the associated factors. eGFR was prospectively evaluated to analyse the predictive value of the tubulopathy on eGFR decrease. Results: At inclusion, 14% of the patients presented with PTD and 5% with CKD. No individual tubular marker, including non-glomerular proteinuria, glycosuria dipstick or hypophosphataemia, registered sufficient performance to identify PTD. We found a significant interaction between tenofovir disoproxil fumarate exposure and ethnicity (P = 0.03) for tubulopathy risk. Tenofovir disoproxil fumarate exposure was associated with PTD in non-Africans [adjusted odds ratio (aOR) = 4.71, P < 10-3], but not in patients of sub-Saharan African origin (aOR = 1.17, P = 0.73). Among the 601 patients followed during a median of 4.3 years, 13% experienced an accelerated eGFR decline. Unlike microalbuminuria and glomerular proteinuria, tubulopathy was not associated with accelerated eGFR decline. Conclusion: PTD is not rare in HIV-infected individuals but is less frequent in sub-Saharan African patients and is associated with tenofovir disoproxil fumarate exposure only in non-Africans. Its diagnosis requires multiple biochemical testing and it is not associated with an accelerated eGFR decline. (© The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.)
Databáze:	MEDLINE
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