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

Abstract

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.

Prevalence and Risk Factors for Renal Insufficiency among Adults Living with HIV in Tanzania: Results from a Cross-Sectional Study in 2020–2021

“…The prevalence of renal insufficiency in this study is comparable to other studies among ALHIV within Tanzania, which reported a prevalence of renal insufficiency (eGFR < 60 mL/min/1.73 m 2 ) of 7–10% among ALHIV in Tanzania [ 10 , 11 , 12 , 13 ]. In general, studies from SSA [ 8 , 9 , 10 , 11 , 12 ] have reported much higher rates of renal insufficiency (7–12%) among ALHIV, using similar definitions (eGFR < 60 mL/min/1.73 m 2 ), compared to studies from central-eastern Europe [ 41 ] and the Asian-pacific region [ 42 , 43 , 44 ] (4–5%), although the settings and populations within the studies were highly variable. Systematic reviews in the US have reported a prevalence of renal insufficiency of up to 15.5% among ALHIV [ 45 , 46 ].…”

“…The eGFR values were also categorized according to the KDIGO 2012 Clinical Practice Guideline [30]. The categories (in mL/min/1.73 m 2 ) include normal/high (≥90), mildly decreased (60-89), mild-moderately decreased (45-59), moderately-severely decreased (30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44), severely decreased (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29), and kidney failure (<15). Participants were considered smokers and alcohol users if they were currently smoking or drinking, or they quit in ≤12 months [34].…”