A cross-sectional study on renal involvement among HIV-infected patients attending a tertiary care hospital in Kolkata

Chatterji, S. N.; Mallik, Sudeshna; Pal, Deepak; Lahre, Dushyant; Chakraborty, Sayan; Ghosh, Manab Kumar; Naskar, Arindam; Pandey, Rajendra; Saha, Bibhuti

doi:10.1093/trstmh/try056

Cited by 3 publications

(4 citation statements)

References 28 publications

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“…The in uence of TDF to the occurrence of kidney disease is still controversial. Using univariate analysis in our study, kidney disease was found to be associated with TDF-containing regimen, which is in line with some ndings [14][15][16][17] . But a study in the USA [18] revealed that TDF-containing regimens did not lead to an increasing of the odds of kidney disease in those with low risk of chronic kidney disease (CKD).…”

Section: Discussionsupporting

confidence: 89%

“…The possible reasons are as follows: ART-experienced patients had lower viral load, but drugrelated kidney damage occurred in them. This can also explain why CD4 cell count is higher in patients with renal damage in our study, while prior study [9,14,19] con rmed low CD4 count was risk factor for kidney damage. Perhaps drug-related renal damage is more signi cant in Chinese population.…”

Section: Discussionsupporting

confidence: 44%

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Prevalence and risk factors for kidney disease in Chinese HIV-Infected patients: A cross-sectional study

Zhao

Pan

Zeng

et al. 2022

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Background Kidney disease is an important comorbidity in HIV-infected patients, and is associated with poor outcomes of these patients. However, data on kidney function in Chinese HIV-Infected patients are scarce. In this study we determined the prevalence of kidney disease in PLWH involving ART-naïve patients and ART-experienced patients in China and explored its associated risk factors. Methods In the cross-sectional study, we recruited hospitalized adult HIV-infected patients. Demographic characteristics, clinical information and laboratory variables were collected. Kidney disease was defined as eGFR < 60 mL/min/1.73 m2, hematuria, proteinuria, or microalbuminuria. We calculated the prevalence of kidney disease and used logistic regression to assess its associated risk factors. Results A total of 501 Chinese adult HIV-infected patients were enrolled, with 446 (89.0%) male and 55 (11.0%) female. Median age was 39 (IQR 30–50) years old. The prevalence of kidney disease was 19.0%. 22 (4.4%) patients had eGFR < 60 mL/min/1.73 m2, 53 (10.6%) patients had hematuria, 11 (2.2%) patients had proteinuria, 40 (8.0%) patients had microalbuminuria. Using univariate analysis, kidney disease was found to be significantly associated with older age, hypertension, diabetes mellitus, duration of HIV, ART and its duration, TDF-containing regimen, HIV viral load < 20 copies/mL, lower hemoglobin and albumin, higher UA, CRP, CHOL and TG. In the multivariate logistic regression analysis, older age (OR 1.031, 95%CI: 1.006–1.058, P = 0.016), diabetes mellitus (OR 3.699, 95%CI: 1.388–9.860, P = 0.009) and Anemia (hemoglobin OR 0.970, 95%CI: 0.954–0.986, P = 0.000) were significantly associated with kidney disease. Conclusions The prevalence of kidney disease in HIV-infected patients in China is high. It is very important to monitor renal function and comprehensively manage the various risk factors in these people. Especially, there is an urgent need to study antiretroviral drugs with no or less nephrotoxicity and with the ability to prevent the virus from depositing in the kidney to protect renal function of HIV-infected patients.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 44%

Prevalence and risk factors for kidney disease in Chinese HIV-Infected patients: A cross-sectional study

Zhao

Pan

Zeng

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…(2) Kidney damage might have been drug-related in ART-experienced PLWH. This can also explain why low CD4 cell count is not associated with renal damage in our study, while prior study [ 11 , 15 , 19 ] confirmed low CD4 count was a risk factor for kidney damage.…”

Section: Discussionsupporting

confidence: 41%

“…Majority of the patients on ART received TDF-containing regimen, which is one of the possible reasons why the prevalence of kidney disease among patients on ART was higher than those not on. Prior studies [ 15 – 18 ] confirmed that TDF was associated with kidney disease. The influence of TDF on kidney function is a well-established phenomenon with specific pathogenetic mechanisms.…”

Section: Discussionmentioning

confidence: 95%

Prevalence and risk factors for kidney disease among hospitalized PLWH in China

et al. 2023

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Background Kidney disease is an important comorbidity in people living with HIV(PLWH), and is associated with poor outcomes. However, data on renal function of PLWH are limited in China so far. In this study we assessed the prevalence of kidney disease in patients either on antiretroviral therapy (ART) or not respectively in a single center in China and explored the possible risk factors associated. Methods In the cross-sectional study, we recruited hospitalized adult PLWH. Demographic characteristics, clinical information and laboratory variables were collected. Kidney disease was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2, and/or isolated hematuria, proteinuria, microalbuminuria. We calculated the prevalence of kidney disease and used logistic regression to assess its associated risk factors. Results A total of 501 adult PLWH were enrolled, 446 (89.0%) males and 55 (11.0%) females. The median age was 39 (IQR 30–50) years old. The prevalence of kidney disease was 19.0%, 22 (4.4%) patients with eGFR < 60 mL/min/1.73 m2, 53 (10.6%) patients with hematuria, 11 (2.2%) patients with proteinuria, and 40 (8.0%) patients with microalbuminuria. 297 (59.3%) patients were receiving ART. The patients on ART had a higher prevalence of renal disease than those had not been administrated with ART (22.6% vs. 13.7%, P = 0.013). On the multivariate logistic regression analysis among patients not on ART, lower haemoglobin (OR 0.994, 95%CI: 0.902–0.988, P = 0.013) were significantly associated with kidney disease. While among those on ART, older age (OR 1.034, 95%CI: 1.003–1.066, P = 0.032), lower haemoglobin (OR 0.968, 95%CI: 0.948–0.988, P = 0.002) and lower albumin (OR 0.912, 95%CI: 0.834–0.997, P = 0.044) were significantly associated with kidney disease. Conclusions The prevalence of kidney disease among hospitalized PLWH in China is high, especially in patients on ART. A larger scale study on Chinese outpatient PLWH should be conducted, so as to precisely assess prevalence of kidney disease in general Chinese PLWH.

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The High Burden of Asymptomatic Kidney Diseases in Individuals with HIV: A Prospective Study from a Tertiary Care Center in India

Giri,

Sahay,

Ismail

et al. 2024

Indian J Nephrol

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Background HIV infection is associated with a significant kidney disease burden. This study is aimed to screen for kidney disease in all HIV patients on highly active anti retroviral therapy (HAART), study clinico-histological correlation, and assess the impact of early diagnosis on the clinical course. Materials and Methods It was a prospective, longitudinal study done in a tertiary care hospital. Adult HIV-infected patients, on HAART for at least 3 months, were screened for kidney disease. Kidney biopsy was done if indicated. Patients were treated as per standard guidelines. Results were analyzed at 3 months. Results Among 1600 patients, 966 were compliant with HAART and were tested. Two hundred and sixty-two patients completed the study duration. Out of these 262 patients 78.2% were receiving tenofovir-based ART regimen. Around 31.2% were hypertensive and 19.8% were diabetic. The mean eGFR was 57.5 ± 24 mL/min/1.73 m2. Around 19.8% had asymptomatic urine abnormalities, 40.1% had proteinuria, and 27.1% had AKI. Acute nephritic syndrome was seen in 16.4%, rapidly progressive renal failure (RPRF) in 13.3%, and CKD in 10.6% patients. Out of 74 patients who underwent biopsy, histology showed chronic tubulointerstitial nephritis in 16 (21.6%), acute tubulointerstitial nephritis in 11 (14.8%), diabetic nephropathy in 10 (13.5%), and thrombotic microangiopathy in 7 patients (9.4%). Higher viral load levels, diabetes mellitus, and age above 60 years were associated with kidney disease. Conclusion Asymptomatic HIV infection has a significant burden of kidney disease. Kidney biopsy is crucial for correct diagnosis and management. The absence of HIV associated nephropathy in proteinuric HIV patients is notable in this study.

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A cross-sectional study on renal involvement among HIV-infected patients attending a tertiary care hospital in Kolkata

Abstract: Renal involvement was less common among those on ART. Low CD4 count and body mass index (BMI) were associated with renal dysfunction. Patients on a tenofovir-based regimen had more renal involvement compared with not on a tenofovir-based regimen.

Cited by 3 publications

References 28 publications

Prevalence and risk factors for kidney disease in Chinese HIV-Infected patients: A cross-sectional study

Prevalence and risk factors for kidney disease in Chinese HIV-Infected patients: A cross-sectional study

Prevalence and risk factors for kidney disease among hospitalized PLWH in China

The High Burden of Asymptomatic Kidney Diseases in Individuals with HIV: A Prospective Study from a Tertiary Care Center in India

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