Lipodystrophy Increases the Risk of CKD Development in HIV-Positive Patients in Switzerland: The LIPOKID Study
| Autor: | Sophie de Seigneux, Helen Kovari, Alexandra Calmy, Matthias Hoffmann, Cornelia Staehelin, Angele Gayet Ageron, Enos Bernasconi, Laurent Merz, Christoph A Fux, Yassine Bouatou, Manuel Battegay |
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| Přispěvatelé: | Pathology, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, Graduate School, AII - Infectious diseases |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty 610 Medicine & health albuminuria lipids 03 medical and health sciences 0302 clinical medicine Clinical Research Internal medicine medicine 030212 general & internal medicine Prospective cohort study ddc:616 Univariate analysis Proportional hazards model business.industry Hazard ratio HIV medicine.disease 030112 virology 3. Good health Nephrology Cohort Lipodystrophy business chronic kidney disease Kidney disease Cohort study |
| Zdroj: | Kidney International Reports, Vol. 3, No 5 (2018) pp. 1089-1099 Kidney International Reports, 3(5), 1089-1099. Elsevier Inc. Bouatou, Yassine; Gayet Ageron, Angele; Bernasconi, Enos; Battegay, Manuel; Hoffmann, Matthias; Staehelin, Cornelia; Merz, Laurent; Kovari, Helen; Fux, Christoph; de Seigneux, Sophie; Calmy, Alexandra (2018). Lipodystrophy Increases the Risk of CKD Development in HIV-Positive Patients in Switzerland: The LIPOKID Study. Kidney international reports, 3(5), pp. 1089-1099. Elsevier 10.1016/j.ekir.2018.04.014 Kidney International Reports |
| ISSN: | 2468-0249 |
| DOI: | 10.1016/j.ekir.2018.04.014 |
| Popis: | Introduction: Antiretroviral therapy has improved the life expectancy of patients living with HIV. However, lipodystrophy syndrome (LD) remains prevalent, affecting mostly patients treated with first-generation antiretroviral drugs. This syndrome is characterized by changes in body fat distribution with or without associated metabolic changes. Here, we studied whether clinically evaluated LD is independently associated with chronic kidney disease (CKD) development (sustained estimated glomerular filtration rate [eGFR] < 60 ml/min per 1.73 m2) in HIV-positive patients. Methods: We conducted a prospective cohort study (the LIPOKID Study) among all the patients from the Swiss HIV Cohort Study (SHCS) with an eGFR >60 ml/min per 1.73 m2 upon their entry into the cohort with more than 3 months of follow-up from January 2002 to August 2016. Cox regression models were used to estimate the association between LD and CKD development. Results: Among the 5384 patients included, 1341 (24.9%) developed LD during the follow-up. The mean follow-up time was 72.3 months (SD ±48.4). In total, 252 patients (4.7%) reached the primary endpoint after a median time of 51.3 months (±SD 39.9 months) from inclusion. A diagnosis of LD significantly increased the risk of an eGFR on univariate analysis (hazard ratio [HR] = 2.72; 95% confidence interval [95% CI] = 2.07−3.58; P < 0.001) and remained significantly higher after adjustment for known HIV and non-HIV risk factors for CKD (HR = 2.37; 95% CI = 1.67−3.36; P < 0.001). The effect of LD on CKD was not mediated through the use of nephrotoxic antiretroviral drugs. Conclusion: Lipodystrophy syndrome is independently associated with CKD after adjustment for previously reported risk factors. |
| Databáze: | OpenAIRE |
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