Prevalence, progression, and management of advanced chronic kidney disease in a cohort of people living with HIV.

Autor: Bonjoch A; Infectious Diseases Department & Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain., Juega J; Nephrology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain., Echeverría P; Infectious Diseases Department & Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain., Puig J; Infectious Diseases Department & Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain., Perez-Alvarez N; Infectious Diseases Department & Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.; Department of Statistics and Operations Research, Technical University of Catalonia-Barcelona Tech, Barcelona, Spain., Bonal J; Nephrology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain., Loste C; Infectious Diseases Department & Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain., Clotet B; Infectious Diseases Department & Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.; Infectious Diseases and Immunity, Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic - Central University of Catalonia (UVic - UCC), Barcelona, Spain.; AIDS Research Institute-IRSICAIXA, Hospital Universitari Germans Trias i Pujol, Badalona; Universitat Autònoma de Barcelona, Barcelona, Spain., Negredo E; Infectious Diseases Department & Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.; Infectious Diseases and Immunity, Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic - Central University of Catalonia (UVic - UCC), Barcelona, Spain.
Jazyk: angličtina
Zdroj: HIV medicine [HIV Med] 2022 Nov; Vol. 23 (10), pp. 1078-1084. Date of Electronic Publication: 2022 Apr 26.
DOI: 10.1111/hiv.13317
Abstrakt: Background: Advanced kidney disease is an emerging problem in people living with HIV despite sustained viral suppression.
Methods: We performed a prospective cohort study to identify people living with HIV with advanced kidney disease according to the Kidney Disease Improving Global Outcomes criteria and to assess disease progression over a 48-week period following the offer of targeted multidisciplinary management.
Results: From our cohort of 3090 individuals, 55 (1.8%, 95% confidence interval [CI] 1.31-2.25) fulfilled the inclusion criteria. Most were male (83.6%), and the median (interquartile range [IQR]) age was 58 (53.25-66.75) years. Nadir CD4 T-cell count was 135.5 (IQR 43.5-262.75) cells/μl, current CD4 T-cell count was 574 (IQR 438.5-816) cells/μl, and 96% had maintained HIV viral suppression. The most frequent comorbidity was arterial hypertension (85.5%). Inadequate antiretroviral dose was detected in three individuals (5.5%), and drug-drug interactions were recorded in eight (14.5%), mainly involving the use of cobicistat (n = 5 [9%]). Four individuals (7%) required modification of their concomitant treatment. Seven (13%) had to start or resume follow-up with a nephrologist. Nine participants (16.4%) experienced an improvement in kidney disease stage, three individuals (5.5%) underwent renal transplantation, and one (2%) started haemodialysis.
Conclusions: Our results show that a multidisciplinary approach, including a critical review of treatment and evaluation of specific requirements, could be useful for anticipating drug-drug interactions and toxicities and for reducing death and hospitalization in people living with HIV with advanced kidney disease.
(© 2022 British HIV Association.)
Databáze: MEDLINE
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