Human Immunodeficiency Virus Infection and the Kidney

Kopp, Jeffrey B.; Fabian, June; Naicker, Saraladevi

doi:10.1016/b978-0-323-05876-6.00056-3

Cited by 2 publications

(2 citation statements)

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“…5 These patients may develop multiple glomerular nephropathies (IgA nephropathy, lupus-like glomerulonephritis, focal and segmental glomerulosclerosis, membranoproliferative glomerulonephritis with cryoglobulinemia, and membranous glomerulopathy) and vascular (thrombotic microangiopathy), tubulointerstitial (tubular nephropathy by drugs, tubulointerstitial immunoallergic nephritis, and Fanconi syndrome), and obstructive nephropathies (nephropathy due to crystal deposition) related to the virus itself, the drugs administered or the coinfections. 6 On the other hand, traditional risk factors for CKD are becoming increasingly prevalent in HIV-infected populations, including aging, diabetes mellitus, hypertension, cardiovascular disease, previous AKI and race/ ethnicity. 7 This has caused the risk factors for CKD in HIV-infected persons to be a combination of traditional and HIV-related factors, including low CD4 counts, high viral load, intravenous drug use, hepatitis C virus (HCV) coinfection, and use of specific antiretroviral drugs.…”

Section: Introductionmentioning

confidence: 99%

Epidemiological, clinical, and laboratory factors associated with chronic kidney disease in Mexican HIV-infected patients

et al. 2019

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Fatores epidemiológicos, clínicos e laboratoriais associados à doença renal crônica em pacientes mexicanos infectados pelo HIV Objetivo: Determinar a prevalência de doença renal crônica (DRC) e os fatores epidemiológicos, clínicos e laboratoriais associados à DRC em pacientes mexicanos infectados pelo HIV. Métodos: Estudo transversal. Incluímos 274 pacientes com HIV/AIDS. A DRC foi definida pela taxa de filtração glomerular estimada (TFGe < 60 mL/min/1,73 m 2 , avaliada pelo CKD-EPI) e pelos critérios de albuminúria das diretrizes do KDIGO. As características clínicas, epidemiológicas e laboratoriais foram comparadas entre pacientes com e sem DRC. Os fatores associados à DRC foram avaliados por análise de regressão logística. Resultados: A média da idade foi de 41 ± 11 anos e 72,3% dos pacientes eram homens. A prevalência global de DRC foi de 11,7% (n = 32); 7,2% (n = 20) foram definidos pelo critério TFGe; 7,6% (n = 21), pelo critério da albuminú-ria; e 3,2% (n = 9), pelos dois critérios para DRC. Os estágios mais frequentemente observados da DRC foram o estágio KDIGO G3A1 com 4,7% (n = 13); estágio KDIGO G1A2 com 3,6% (n = 10) e estágio KDIGO G3A2 com 1,7% (n = 5). Os fatores associados à DRC foram o uso de abacavir/lamivudina (OR 3,2; IC95% 1,1-8,9; p = 0,03), contagem de linfócitos CD4 < 400 células/ μL (OR 2,6; 95% 1,03-6,4, p = 0,04), idade (OR 1,1; IC95% 1,04-1,2, p = 0,001) e albuminúria (OR 19,98; IC95%: 5,5-72,2; p < 0,001). Conclusões: A DRC foi uma complicação frequente em pacientes infectados pelo HIV. Esses achados confirmam a importância do rastreamento e da detecção precoce da DRC, bem como a importância de identificar e tratar os fatores de risco tradicionais e não tradicionais associados à DRC. ResumoPalavras-chave: Insuficiência Renal Crôni-ca; HIV; Insuficiência Renal. Aim:To determine the prevalence of chronic kidney disease (CKD) and the epidemiological, clinical, and laboratory factors associated with CKD in Mexican HIV-infected patients. Methods: Crosssectional study. We included 274 patients with HIV/AIDS. CKD was defined by the estimated glomerular filtration rate (eGFR < 60 mL/min/1.73 m 2 assessed by CKD-EPI) and albuminuria criteria from KDIGO guidelines. Clinical, epidemiological, and laboratory characteristics were compared between patients with and without CKD. The factors associated with CKD were assessed by logistic regression analysis. Results: The mean age was 41±11 years, and 72.3% of the patients were men. The global prevalence of CKD was 11.7% (n = 32); 7.2% (n = 20) were defined by eGFR criterion; 7.6% (n = 21), by the albuminuria criterion; and 3.2% (n = 9), by both CKD criteria. The most frequently observed stages of CKD were KDIGO G3A1 stage with 4.7% (n = 13), KDIGO G1A2 stage with 3.6% (n = 10) and KDIGO G3A2 stage with 1.7% (n = 5). The factors associated with CKD were use of abacavir/lamivudine (OR 3.2; 95% CI 1.1-8.9; p = 0.03), a CD4 lymphocyte count < 400 cells/μL (OR 2.6; 95% 1.03-6.4, p = 0.04), age (OR 1.1; 95% CI 1.04-1.2, p = 0.001) and albuminuria (OR 19.98...

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Section: Introductionmentioning

confidence: 99%

Epidemiological, clinical, and laboratory factors associated with chronic kidney disease in Mexican HIV-infected patients

et al. 2019

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“…Selanjutnya, inflamasi kronik yang bersifat sitopatik terhadap tubulus dan glomerulus juga akan semakin berkurang. 19,20 Penggunaan protease inhibitor bersamaan dengan TDF dapat menyebabkan peningkatan kadar TDF dalam darah dengan menghambat bersihan TDF dari ginjal. 13 Kadar TDF dalam darah dapat meningkat hingga 20-37% saat dikombinasikan dengan protease inhibitor.…”

Section: Diskusiunclassified

Faktor-Faktor yang Memengaruhi Terjadinya Penurunan Cepat Laju Filtrasi Glomerulus pada Pasien HIV/AIDS dengan Pengobatan Tenofovir Disoproksil Fumarat

Yuriandro¹,

Yunihastuti²,

Marbun³

et al. 2019

JPDI

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Pendahuluan. Pengobatan dengan tenofovir pada pasien HIV/AIDS mempunyai risiko timbulnya efek samping pada ginjal berupa penurunan cepat laju filtrasi glomerulus (LFG) (> 5 ml/menit/1,72 m2) setelah pengobatan selama setahun. Besarnya angka kejadian penurunan cepat LFG dan faktor yang memengaruhinya selama ini masih kontradiktif dan belum dikaji secara lengkap. Penelitian ini dilakukan untuk mengetahui angka insiden nefrotoksiksitas terkait tenofovir dan faktor-faktor yang memengaruhinya.Metode. Penelitian dengan desain kohort retrospektif dilakukan di unit pelayanan terpadu HIV RSUPN Cipto Mangunkusumo Jakarta pada pasien yang memulai pengobatan tenofovir sejak Januari 2010 sampai dengan Januari 2015 dengan metode sampling konsekutif. Kriteria inklusi yaitu pasien yang berobat minimal setahun dan mempunyai LFG awal > 60 ml/menit/1,72 m2. Kriteria eksklusi subjek yaitu apabila tidak ada data LFG ulang setelah satu tahun pengobatan. Penelitian dilakukan dengan pengambilan data sekunder melalui penelusuran rekam medis. Variabel-variabel yang berpotensi berhubungan dengan penurunan cepat LFG dianalisis dengan regresi logistik menggunakan program SPSS.Hasil. Sebanyak 164 subjek diikutkan dalam penelitian. Insiden penurunan cepat LFG didapatkan pada 87 subjek (53% IK 95%: 45 - 60,4%). Faktor-faktor yang berpengaruh adalah jenis kelamin laki-laki (OR 4,0 IK 95%: 1,1 - 4,8), jumlah CD4 dibawah 100 sel/mm3 (OR 3,7 IK 95%: 1,7 – 8,1), Penambahan berat badan >20 % (OR 4,0 IK 95% 1,0 – 4,8) dan nilai LFG sebelum pengobatan >90 ml/menit/1,72 m2 (OR 9,8; IK 95%: 2,3 – 42,1).Simpulan. Insiden penurunan cepat LFG setelah pemakaian tenofovir selama setahun adalah 53%. Faktor risiko yang berpengaruh adalah jenis kelamin laki-laki, jumlah CD4 kurang dari 100 sel/mm3, penambahan berat badan > 20%, dan LFG awal sebelum pengobatan > 90 ml/menit/1,72 m2.Kata Kunci: HIV/AIDS, Penurunan cepat LFG, Tenofovir Factors Affecting Rapid Decline in Glomerular Filtration Rate Occurence in HIV/AIDS Patient Treated with TenofovirIntroduction. Tenofovir treatment in HIV/AIDS patient has a possible side effect for kidney, which is rapid decline in glomerular filtration rate (GFR) (> 5 cc/min/1,72 m2) after patient undergo tenofovir treatment for one year. The incidence rate for rapid decline in GFR and factors affecting it are still contradictive and not assessed completely. To identify cumulative incidence and factors affecting tenofovir related nephrotoxicity.Methods. A retrospective cohort study was conducted in HIV/AIDS outpatient clinic in Cipto Mangunkusumo Hospital. We include patients who start to take tenofovir as their medication from January 2010 until January 2015 with consecutive sampling method. Inclusion criterias are minimum one year of tenofovir treatment and baseline GFR > 60 cc/minute/1,72 m2. Subject would be excluded if there were no data for GFR evaluation after one year. Our study used secondary data, taken from patient’s medical record. Logistic regression test was used for variabels that could potentially affect rapid decline in glomerular filtration rate.Results. 164 subjects were included for analysis and we found incidence rate for rapid decline in GFR after one year of tenofovir medication in 87 subjects (53%; 95% CI: 45-60,4%). Factors those affecting rapid decline in GFR are male gender (OR 4,0; 95% CI: 1,1-4,8), CD4 cell count below 100 cell/mm3 (OR 3,7; 95% CI: 1,7 – 8,1), weight increase > 20 % (OR 4,0; 95% CI: 1,0 – 4,8), and baseline GFR > 90 cc/min/1,72 m2 (OR 9,8; 95% CI: 2,3 – 42,1).Conclusion. The incidence rate for rapid decline in GFR aftre one year of tenofovir medication in HIV/AIDS patients in Cipto Mangunkusumo hospital is 53%. Risk Factors that affecting nephrotoxicity are male gender, CD4 cell count below 100 cell/mm3, weight increase > 20%, and baseline GFR > 90 cc/min/1,72 m2.

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Human Immunodeficiency Virus Infection and the Kidney

Cited by 2 publications

References 28 publications

Epidemiological, clinical, and laboratory factors associated with chronic kidney disease in Mexican HIV-infected patients

Epidemiological, clinical, and laboratory factors associated with chronic kidney disease in Mexican HIV-infected patients

Faktor-Faktor yang Memengaruhi Terjadinya Penurunan Cepat Laju Filtrasi Glomerulus pada Pasien HIV/AIDS dengan Pengobatan Tenofovir Disoproksil Fumarat

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