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Published on: July 24, 2013
Racial differences in chronic kidney disease incidence and progression among individuals with HIV
Deidra C Crews1, Bernard G Jaar
1Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Insights
African Americans with HIV face a higher risk of chronic kidney disease (CKD) progression and end-stage renal disease compared to white individuals. Early screening for kidney disease in high-risk HIV patients is crucial.
Area of Science:
- Nephrology
- Infectious Diseases
- Public Health
Background:
- Chronic kidney disease (CKD) is a significant concern in the human immunodeficiency virus (HIV) population.
- Racial disparities in CKD prevalence and progression exist in the general population.
Discussion:
- Lucas et al. studied CKD in African American and white individuals with HIV.
- African Americans exhibited a higher risk of CKD progression and end-stage renal disease compared to white individuals.
- Findings align with known racial differences in CKD in the general population.
Key Insights:
- HIV-infected African Americans experience more aggressive CKD progression.
- Increased rates of estimated glomerular filtration rate decline observed in African Americans.
- Markedly increased progression to end-stage renal disease in African Americans with HIV.
Outlook:
- Highlights the need for targeted CKD screening in high-risk HIV patients.
- Emphasizes understanding racial differences in HIV-associated nephropathy.
- Informs clinical management strategies for kidney disease in diverse HIV populations.
Abstract:
This Practice Point commentary discusses the findings of Lucas et al.'s longitudinal cohort study of chronic kidney disease (CKD) in African American and white individuals with HIV. The study found that--compared with whites--African Americans had a slightly increased risk of incident CKD, but markedly increased rates of estimated glomerular filtration rate decline and progression to end-stage renal disease. This commentary details the clinical implications and limitations of these findings in the context of known racial differences in CKD prevalence and progression to end-stage renal disease in the general population and highlights the importance of screening high-risk HIV patients for kidney disease. CKD is common among HIV patients, and-as in the general population-has a more-aggressive course among African Americans than whites.
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