Chronic kidney disease in the global adult HIV-infected population: A systematic review and meta-analysis

Ekrikpo, Udeme; Kengne, André Pascal; Bello, Aminu K.; Effa, Emmanuel; Noubiap, Jean Jacques; Salako, Babatunde Lawal; Rayner, Brian; Remuzzi, Giuseppe; Okpechi, Ikechi G.

doi:10.1371/journal.pone.0195443

Cited by 140 publications

(156 citation statements)

References 122 publications

(156 reference statements)

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“…Globally, for example, HIV-related CKD is most prevalent in Africa, with prevalence rates of 7.9%. 9 Furthermore, within the African continent, the prevalence of HIV-related CKD is highest within the West African subregion at 14.6% compared with Southern Africa, which has estimated rates of 3.2%. 9 CKD in LMICs tends to occur earlier and appears to be more severe.…”

Section: Ckd In Lmicsmentioning

confidence: 99%

Preventing CKD in Low- and Middle-Income Countries: A Call for Urgent Action

Ameh¹,

Ekrikpo

Kengne

2020

Kidney International Reports

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The epidemiologic transition occurring in low-and middle-income countries (LMICs) has led to a surge in chronic kidney disease (CKD) prevalence because of a combination of highly prevalent chronic noncommunicable diseases (NCDs) and communicable diseases (CDs). The progressive rise in CKD prevalence in LMICs threatens the existing weak health systems in these countries as care for advanced CKD remains largely unavailable and unaffordable. An interplay of low literacy levels, poor health-seeking behavior, inadequate health care funding, weak health systems, and lack of skilled nephrology workforce has made it difficult for adequate CKD preventive measures to be implemented. Primary, secondary, and tertiary prevention measures need to be instituted in LMICs by a collaboration of governmental and nongovernmental organizations to stem this tide and help prevent deaths from other NCDs that share similar risk factors with CKD. For these to be effective, locally relevant knowledge is needed to contextualize existing prevention and control solutions, or to develop novel and more appropriate solutions for LMICs.Kidney Int Rep (2020) 5, 255-262; https://doi.

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Section: Ckd In Lmicsmentioning

confidence: 99%

Preventing CKD in Low- and Middle-Income Countries: A Call for Urgent Action

Ameh¹,

Ekrikpo

Kengne

2020

Kidney International Reports

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“…A recent systematic review and meta‐analysis estimated the pooled prevalence of CKD [estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m 2 ] in PLWH in North America to range from a low of 6.5% [95% confidence interval (CI) 4.9–8.5%] using the Cockcroft–Gault (C‐G) formula to a high of 7.4% (95% CI 6.0–9.1%) using the Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI) formula . Studies based on varying levels of GFR reduction and proteinuria have suggested that CKD prevalence in PLWH may be as high as 33% .…”

Section: Introductionmentioning

confidence: 99%

Validation of the Data Collection on Adverse Events of Anti‐HIV Drugs (D:A:D) chronic kidney disease risk score in HIV‐infected patients in the USA

Mills¹,

Schulman²,

Fusco³

et al. 2020

HIV Medicine

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Objectives The aim of the study was to assess the validity of an easy‐to‐calculate chronic kidney disease (CKD) risk score developed by the Data Collection on Adverse Events of Anti‐HIV Drugs (D:A:D) group in a longitudinal observational study of people living with HIV (PLWH) in the USA. Methods PLWH (2002–2016) without prior exposure to potentially nephrotoxic antiretroviral agents and with at least three estimated glomerular filtration rate (eGFR) test results were identified in the Observational Pharmaco‐Epidemiology Research and Analysis (OPERA®) cohort. Three samples were drawn independently using the same eligibility criteria but each using a different eGFR equation, specifically the Cockcroft–Gault (C‐G), Modification of Diet in Renal Disease (MDRD) or Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI) eGFR estimation method. Full and short D:A:D risk scores were applied. CKD was defined as a confirmed decrease in eGFR to < 60 mL/min/1.73 m2 (stages 3–5). Poisson models estimated the association between CKD incidence and a one‐point increase in the continuous risk score. The incidence rate ratio (IRR), adjusted IRR (aIRR), and Harrell's discrimination statistic were used to assess validity. Results There were 19 444, 22 727 and 22 748 PLWH in the OPERA C‐G, CKD‐EPI and MDRD samples, respectively. The median (minimum–maximum) follow‐up duration was 6.1 (0.3–9.1) years in the D:A:D cohort and ranged from 3.2 to 3.5 (0.2–15.5) years in the OPERA validation samples. The observation time for the majority of PLWH in the D:A:D cohort began prior to 2006, in stark contrast to the OPERA validation samples, where the majority of PLWH were observed after 2011. The CKD incidence ranged from 7.3 per 1000 person‐years [95% confidence interval (CI) 6.8, 7.9 per 1000 person‐years] in OPERA C‐G to 11.0 (95% CI 10.4, 11.6 per 1000 person‐years) in OPERA MDRD. In OPERA samples, IRRs by risk group and adjusted IRRs (full risk score) were similar to those in the D:A:D derivation cohort (adjusted IRR 1.3; 95% CI 1.3, 1.3). Harrell's c‐statistic ranged from 0.87 to 0.92 in the OPERA samples, comparable to that in the derivation cohort (0.92). Results for short scores were similar. Conclusions The findings support the validity of the D:A:D risk scoring method for assessing CKD (stages 3–5) probability in an exclusively USA‐based sample regardless of eGFR method.

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“…Contrary, treatment with an erythropoiesis-stimulating agent or iron, results in increased circulating immature RBCs that have a shorter glycaemic exposure time for glycation to occur, resulting in reduced HbA1c levels, with no significant change in mean glucose levels [10]. There are also several other diseases, prevalent in Africa, that affect the clinical utility of HbA1c and for which alternative markers may be necessary, including sickle-cell disease in the more endemic malaria prone regions, as well as HIV/AIDS and tuberculosis [11,12].…”

Section: Introductionmentioning

confidence: 99%

“…Fructosamine and GA have shorter half-lives than HbA1c, thus reflecting very recent (1-3 weeks) glycaemic control [16], potentially lessening the confounding effect of shortened RBC survival or high RBC turnover. However, the effect of CKD on the agreement between these indices of glycaemic control has yet to be assessed in the African context; where there is a high frequency of factors affecting HbA1c [11,12].…”

Section: Introductionmentioning

confidence: 99%

The agreement between fasting glucose and markers of chronic glycaemic exposure in individuals with and without chronic kidney disease: a cross-sectional study

et al. 2020

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Background: To assess whether the agreement between fasting glucose and glycated proteins is affected by chronic kidney disease (CKD) in a community-based sample of 1621 mixed-ancestry South Africans. Methods: CKD was defined as an estimated glomerular filtration rate < 60 ml/min/1.73 m 2. Fasting plasma glucose and haemoglobin A1c (HbA1c) concentrations were measured by enzymatic hexokinase method and highperformance liquid chromatography, respectively, with fructosamine and glycated albumin measured by immunoturbidimetry and enzymatic method, respectively. Results: Of those with CKD (n = 96), 79, 16 and 5% where in stages 3, 4 and 5, respectively. Those with CKD had higher levels of HbA1c (6.2 vs. 5.7%; p < 0.0001), glycated albumin (15.0 vs. 13.0%; p < 0.0001) and fructosamine levels (269.7 vs. 236.4 μmol/l; p < 0.0001), compared to those without CKD. Higher fasting glucose levels were associated with higher HbA1c, glycated albumin and fructosamine, independent of age, gender, and CKD. However, the association with HbA1c and glycated albumin differed by CKD status, at the upper concentrations of the respective markers (interaction term for both: p ≤ 0.095). Conclusion: Our results suggest that although HbA1c and glycated albumin perform acceptably under conditions of normoglycaemia, these markers correlate less well with blood glucose levels in people with CKD who are not on dialysis.

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Chronic kidney disease in the global adult HIV-infected population: A systematic review and meta-analysis

Cited by 140 publications

References 122 publications

Preventing CKD in Low- and Middle-Income Countries: A Call for Urgent Action

Preventing CKD in Low- and Middle-Income Countries: A Call for Urgent Action

Validation of the Data Collection on Adverse Events of Anti‐HIV Drugs (D:A:D) chronic kidney disease risk score in HIV‐infected patients in the USA

The agreement between fasting glucose and markers of chronic glycaemic exposure in individuals with and without chronic kidney disease: a cross-sectional study

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