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The incidence of and risk factors for hospitalized acute kidney injury among people living with HIV on antiretroviral treatment.

Authors :
Muiru, Anthony N.
Madden, Erin
Chilingirian, Ani
Rubinsky, Anna D.
Scherzer, Rebecca
Moore, Richard
Villalobos, Celia P. Corona
Monroy Trujillo, Jose Manuel
Parikh, Chirag R.
Hsu, Chi‐yuan
Shlipak, Michael G.
Estrella, Michelle M.
Source :
HIV Medicine; Jul2022, Vol. 23 Issue 6, p611-619, 9p
Publication Year :
2022

Abstract

Objectives: The epidemiology of hospitalized acute kidney injury (AKI) among people living with HIV (PLWH) in the era of modern antiretroviral therapy (ART) for all PLWH is not well characterized. We evaluated the incidence of and risk factors for hospitalized AKI from 2005 to 2015 among PLWH on ART. Methods: We conducted a retrospective analysis of PLWH from the Johns Hopkins HIV Clinical Cohort. We defined hospitalized AKI as a rise of ≥ 0.3 mg/dL in serum creatinine (SCr) within any 48‐h period or a 50% increase in SCr from baseline and assessed associations of risk factors with incident AKI using multivariate Cox regression models. Results: Most participants (75%) were black, 34% were female, and the mean age was 43 years. The incidence of AKI fluctuated annually, peaking at 40 per 1000 person‐years (PY) [95% confidence interval (CI) 22–69 per 1000 PY] in 2007, and reached a nadir of 20 per 1000 PY (95% CI 11–34 per 1000 PY) in 2010. There was no significant temporal trend (−3.3% change per year; 95% CI −8.6 to 2.3%; P = 0.24). After multivariable adjustment, characteristics independently associated with AKI included black race [hazard ratio (HR) 2.44; 95% CI 1.42–4.20], hypertension (HR 1.62; 95% CI 1.09–2.38), dipstick proteinuria > 1 (HR 1.86; 95% CI 1.07–3.23), a history of AIDS (HR 1.82; 95% CI 1.29–2.56), CD4 count < 200 cells/µL (HR 1.46; 95% CI 1.02–2.07), and lower serum albumin (HR 1.73 per 1 g/dL decrease; 95% CI 1.02–2.07). Conclusions: In this contemporary cohort of PLWH, the annual incidence of first AKI fluctuated during the study period. Attention to modifiable AKI risk factors and social determinants of health may further reduce AKI incidence among PLWH. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
14642662
Volume :
23
Issue :
6
Database :
Complementary Index
Journal :
HIV Medicine
Publication Type :
Academic Journal
Accession number :
157331103
Full Text :
https://doi.org/10.1111/hiv.13216