Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/10284
Title: Screening for decreased glomerular filtration rate and associated risk factors in a cohort of HIV-infected patients in a middle-income country
Authors: Silva, Patrícia Santiago
Grinsztejn, Beatriz Gilda Jegerhorn
Friedman, Ruth Khalili
Cunha, Cynthia Braga da Cunha
Coelho, Lara Esteves
Luz, Paula Mendes
Oliveira, Albanita Viana de
Moreira, Ronaldo Ismério
Cardoso, Sandra Wagner
Santos, Valdiléa Gonçalves Veloso dos
Suassuna, José Hermógenes Rocco
Affilliation: Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil / Universidade do Estado do Rio de Janeiro. Faculdade de Ciências Médicas. Hospital Universitário Pedro Ernesto. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Faculdade de Ciências Médicas. Departamento de Patologia. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasi
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Faculdade de Ciências Médicas. Hospital Universitário Pedro Ernesto. Rio de Janeiro, RJ, Brasil.
Abstract: With the introduction of combined active antiretroviral therapy and the improved survival of HIV-infected patients, degenerative diseases and drug toxicity have emerged as long-term concerns. We studied the prevalence of decreased glomerular filtration rate (GFR) and associated risk factors in a cohort of HIV-infected patients from a middle-income country. Our cross-sectional study included all adult patients who attended an urban outpatient clinic in 2008. GFR was estimated using the CKD-EPI equation. The prevalence ratio (PR) of decreased GFR (defined as ,60 mL/min/1.73 m2) was estimated using generalizing linear models assuming a Poisson distribution. We analyzed data from 1,970 patients, of which 82.9% had been exposed to ART. A total of 249 patients (12.6%) had a GFR between 60 and 89 mL/min/1.73 m2, 3.1% had a GFR between 30 and 59, 0.3% had a GFR between 15 and 29, and 0.4% had a GFR ,15. Decreased GFR was found in only 74 patients (3.8%). In the multivariate regression model, the factors that were independently associated with a GFR below 60 mL/min/1.73 m2 were as follows: age $50 years (PR = 3.4; 95% CI: 1.7–6.8), diabetes (PR = 2.0; 95% CI: 1.2–3.4), hypertension (PR = 2.0; 95% CI: 1.3–3.2), current CD4+ cell count ,350 cells/mm3 (PR = 2.1; 95% CI: 1.3–3.3), past exposure to tenofovir (PR = 4.7; 95% CI: 2.3–9.4) and past exposure to indinavir (PR = 1.7; 95% CI: 1.0–2.8). As in high-income countries, CKD was the predominant form of kidney involvement among HIV-infected individuals in our setting. The risk factors associated with decreased glomerular filtration were broad and included virus-related factors as well as degenerative and nephrotoxic factors. Despite the potential for nephrotoxicity associated with some antiretroviral drugs, in the short-term, advanced chronic renal disease remains very rare.
Keywords: Acquired Immunodeficiency Syndrome
Glomerular filtration rate
Highly active antiretroviral therapy
Statistical analysis
DeCS: Síndrome de Imunodeficiência Adquirida
Taxa de filtração glomerular
Terapia antirretroviral de alta atividade
Análise estatística
Issue Date: 2014
Publisher: Public Library of Science
Citation: SILVA, Patrícia Santiago et al. Screening for decreased glomerular filtration rate and associated risk factors in a cohort of HIV-infected patients in a middle-income country. Plos One, v. 9, n. 4, p. 1-7, Apr. 2014.
DOI: 10.1371/journal.pone.0093748
ISSN: 1932-6203
Copyright: open access
Appears in Collections:INI - Artigos de Periódicos




FacebookTwitterDeliciousLinkedInGoogle BookmarksBibTex Format mendeley Endnote DiggMySpace

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.