Survival and morbidity of HIV patients on hemodialysis and peritoneal dialysis: one center’s experience and review of the literature

Soleymanian, Tayebeh; Raman, Suresh; Shannaq, Fouad Naser; Richardson, Robert; Jassal, Sarbjit V.; Bargman, Joanne M.; Oreopoulos, Dimitrios G.

doi:10.1007/s11255-006-0080-8

Cited by 15 publications

(10 citation statements)

References 14 publications

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“…We found that one year survival rate of HIV positive patient was 61.4%. Our survival rate of HIV patients is lower than reported findings in the international literature that range from 74 to 95.2% in HIV positive patient receiving haemodialysis [ 10 , 17 , 18 , 31 – 33 ]. In the USA one year survival of HIV-positive patients receiving chronic haemodialysis was estimated at 74% [ 10 , 31 ].…”

Section: Discussioncontrasting

confidence: 73%

“…In the study of Tourret et al and Trullas et al in Europe survival rate was 93.8 and 95.2% respectively [ 17 , 32 ]. Tayebey et al in Iran, found a rate of 75% [ 33 ], and Fabian et al in South Africa recently reported a 100% survival rate of HIV-positive patients [ 18 ]. In the contrary our survival rate is higher compared to the studies of Zako et al in South Africa (51%) [ 34 ] and Rodriguez et al (46%) [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

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Survival of HIV infected patients on maintenance hemodialysis in Cameroon: a comparative study

et al. 2018

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BackgroundThere are conflicting reports on the impact of HIV in the era of combined antiretroviral (c-ART) on survival of patient with ESKD. We aimed to compare the one-year survival of HIV positive patients to that of their HIV negative counterparts with ESKD on maintenance haemodialysis in Cameroon.MethodsThis was a retrospective cohort study conducted in the haemodialysis units of the Douala and Yaoundé General Hospitals. All HIV positive patients treated by maintenance haemodialysis between January 2007 and March 2015 were included. A comparative group of HIV negative patients with ESKD were matched for age, sex, co morbidities, year of dialysis initiation and haemodialysis unit. Relevant data at the time of haemodialysis initiation and during the first year of haemodialysis was noted. Survival was analysed using the Kaplan Meier and Cox regression hazard ratio estimator. A p value < 0.05 was considered statistically significant.ResultsA total of 57 patients with HIV and 57 without HIV were included. Mean age was 46.25 ± 11.41 years, and 52.6% were females in both groups. HIV nephropathy (50.9%) was the main presumed aetiology of ESKD in the HIV group, while chronic glomerulonephritis (33.3%) and diabetes (21.1%) were the main aetiologies in the HIV negative group. At initiation of dialysis, the median CD4 count was 212 cell/mm3 (IQR; 138–455) and 77.2% were receiving c-ART. The proportion of patients who initiated dialysis with a temporary venous catheter was similar in both groups (p = 0.06). After one year on haemodialysis, survival rate was lower in the HIV positive group compared to the HIV negative group (61.4%/78.9%, HR: 2.05; 95% CI: 1.03–4.08; p = 0.042).Kaplan Meier survival curve was in direction of a lower survival in HIV positive group (p = 0.052).ConclusionThe one year survival of HIV positive patients on maintenance haemodialysis in Cameroon seems to be lower compared to their HIV negative counterparts.

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Section: Discussioncontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Survival of HIV infected patients on maintenance hemodialysis in Cameroon: a comparative study

et al. 2018

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“…Observational studies demonstrate similar outcomes between hemodialysis (HD) and peritoneal dialysis (PD) among ART-treated individuals, and modality selection depends upon patient preference and regional resources. 123, 124 Arteriovenous fistulas are the preferred vascular access, as arteriovenous grafts and catheters are associated with higher risk of infection and thrombosis. 125 There is no evidence supporting isolation of HIV-positive patients in HD units, except those with HBV co-infection.…”

Section: Ckd Progression and Eskd In The Setting Of Hiv Infectionmentioning

confidence: 99%

Kidney disease in the setting of HIV infection: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Swanepoel

Atta

D’Agati

et al. 2018

Kidney International

185

144

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HIV-positive individuals are at increased risk for kidney disease, including HIV-associated nephropathy, noncollapsing focal segmental glomerulosclerosis, immune-complex kidney disease, and comorbid kidney disease, as well as kidney injury resulting from prolonged exposure to antiretroviral therapy or from opportunistic infections. Clinical guidelines for kidney disease prevention and treatment in HIV-positive individuals are largely extrapolated from studies in the general population, and do not fully incorporate existing knowledge of the unique HIV-related pathways and genetic factors that contribute to the risk of kidney disease in this population. We convened an international panel of experts in nephrology, renal pathology, and infectious diseases to define the pathology of kidney disease in the setting of HIV infection; describe the role of genetics in the natural history, diagnosis, and treatment of kidney disease in HIV-positive individuals; characterize the renal risk-benefit of antiretroviral therapy for HIV treatment and prevention; and define best practices for the prevention and management of kidney disease in HIV-positive individuals.

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“…The choice of dialysis modality does not impact on survival. [16] Transplantation has been performed with success in HIV-infected patients. Preliminary short-term data in liver, kidney, and heart transplant recipients suggest that patient survival rates are similar to those in highrisk HIV-uninfected transplant recipients and there has been no increase in the prevalence of opportunistic infections.…”

Section: Eskd Due To Hiv-ckdmentioning

confidence: 99%

Important causes of chronic kidney disease in South Africa

et al. 2015

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In hypertensive patients without chronic kidney disease (CKD) the goal is to keep blood pressure (BP) at ≤140/90 mmHg. When CKD is present, especially where there is proteinuria of ≥0.5 g/day, the goal is a BP of ≤130/80 mmHg. Lifestyle measures are mandatory, especially limitation of salt intake, ingestion of adequate quantities of potassium, and weight control. Patients with stages 4 -5 CKD must be carefully monitored for hyperkalaemia and deteriorating kidney function if angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) are used, especially in patients >60 years of age with diabetes or atherosclerosis. BP should be regularly monitored and, where possible, home BP-measuring devices are recommended for optimal control.Guidelines on the use of antidiabetic agents in CKD are presented, with the warning that metformin is contraindicated in patients with stages 4 -5 CKD.There is a wide clinical spectrum of renal disease in the course of HIV infection, including acute kidney injury, electrolyte and acid-base disturbances, HIV-associated glomerular disease, acute-on-chronic renal disease and side-effects related to the treatment of HIV.

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Survival and morbidity of HIV patients on hemodialysis and peritoneal dialysis: one center’s experience and review of the literature

Cited by 15 publications

References 14 publications

Survival of HIV infected patients on maintenance hemodialysis in Cameroon: a comparative study

Survival of HIV infected patients on maintenance hemodialysis in Cameroon: a comparative study

Kidney disease in the setting of HIV infection: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Important causes of chronic kidney disease in South Africa

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