肾脏疾病
入射(几何)
医学
人类免疫缺陷病毒(HIV)
风险因素
内科学
环境卫生
免疫学
物理
光学
作者
Houlei Gao,Jiajia Zhang,Xueying Yang,Shujie Chen,Roy Mathew,Sharon Weissman,Bankole Olatosi,Xiaoming Li
出处
期刊:AIDS
[Ovid Technologies (Wolters Kluwer)]
日期:2023-07-18
卷期号:37 (12): 1783-1790
标识
DOI:10.1097/qad.0000000000003662
摘要
We investigate the incidence of chronic kidney disease (CKD) among people with HIV (PWH) and the dynamic risk factors associated with CKD incidence.A population-based cohort study of PWH in South Carolina.Adults (age ≥18 years) PWH diagnosed between 2006 and 2019 who were CKD-free at baseline were included. The associations of HIV-related risk factors and conventional risk factors with the incidence of CKD were investigated during the overall study period and by different follow-up periods (i.e. 5, 10, and 15 years) by multivariate logistic regression.Among 9514 PWH, the incidence of CKD was 12.39 per 1000 person-years. The overall model indicated that conventional risk factors, such as hypertension, dyslipidemia, cardiovascular disease, and diabetes, were significantly associated with a higher risk of developing CKD. HIV-related characteristics, such as high percentage of days with viral suppression, recent CD4 + cell count, and percentage of retention in care, were associated with a lower risk of CKD compared with their counterparts. In the subgroup analysis, the results were similar for the 5-year and 6-10 years follow-up groups. Among patients who did not develop CKD by the 10th year, the risk factors for developing CKD within 11-15 years were dyslipidemia, diabetes, low recent CD4 + cell count, and short duration of retention in care while other predictors vanished.Diabetes, CD4 + cell count, and retention in care were persistently associated with CKD despite of follow-up duration. Closely monitoring diabetes and improving CD4 + cell count and retention in care are important to lower the risk of CKD in PWH.
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