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The impact of HIV on chronic kidney disease outcomes

A I Choi1, R A Rodriguez, P Bacchetti

  • 1Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California 94110, USA. andy.choi@ucsf.edu

Kidney International
|September 7, 2007
PubMed

Insights

Outcomes for patients with chronic kidney disease (CKD) and human immunodeficiency virus (HIV) are unclear. HIV-infected Black patients with CKD face higher risks of death and kidney function decline compared to diabetic patients.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Public Health

Background:

  • Chronic kidney disease (CKD) is a recognized complication of human immunodeficiency virus (HIV) infection.
  • Limited data exists on the outcomes of CKD patients who are also infected with HIV.

Purpose of the Study:

  • To investigate the risks of death, end-stage renal disease (ESRD), and estimated glomerular filtration rate (eGFR) decline in a national cohort of CKD patients with and without HIV.
  • To compare outcomes between HIV-infected CKD patients and diabetic CKD patients, stratified by race.

Main Methods:

  • Analysis of a national sample of 202,927 patients with stage 3 or higher CKD.
  • Inclusion of patients with HIV, diabetes, or neither condition.
  • Assessment of mortality, ESRD incidence, and mean annual eGFR decline over a median follow-up of 3.8 years.

Main Results:

  • HIV-infected Black patients with CKD showed higher mortality and similar risks for ESRD and eGFR decline compared to Black patients with diabetes.
  • HIV-infected White patients with CKD had higher mortality but a lower risk of ESRD compared to White patients with diabetes.
  • HIV was diagnosed in 0.3% of the national CKD cohort.

Conclusions:

  • The study underscores a need for further research into mortality and ESRD mechanisms in the HIV-infected population with CKD.
  • Outcomes differ significantly between HIV-infected and diabetic CKD patients, with racial disparities observed.
  • This research highlights critical differences in CKD progression and survival based on HIV status and race.

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