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Spectrum of chronic kidney disease in HIV-infected patients

L J Campbell1, F Ibrahim, M Fisher

  • 1Academic Department of HIV/GU Medicine, King's College London, London, France.

HIV Medicine
|February 20, 2009
PubMed

Insights

Chronic kidney disease (CKD) affects 2.4% of HIV patients, often linked to metabolic diseases. Certain HIV medications, indinavir (IDV) and tenofovir (TFV), accelerate kidney function decline in those with CKD.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Pharmacology

Background:

  • Chronic kidney disease (CKD) is a significant concern in the human immunodeficiency virus (HIV)-infected population.
  • Understanding the prevalence, causes, and renal function trends in HIV patients is crucial for effective management.

Purpose of the Study:

  • To investigate the prevalence and aetiology of CKD in HIV-infected patients.
  • To analyze trends in estimated glomerular filtration rate (eGFR) in this cohort.
  • To assess the impact of specific antiretroviral drugs on renal function.

Main Methods:

  • A review of CKD cases was conducted at King's College and Brighton Hospitals, UK.
  • CKD was defined as eGFR <60 mL/min for ≥3 months.
  • Longitudinal eGFR slopes were analyzed in relation to exposure to indinavir (IDV) or tenofovir (TFV).

Main Results:

  • CKD prevalence was 2.4% among HIV patients.
  • Aetiology varied by ethnicity: HIV-associated nephropathy in Black patients, and metabolic/vascular diseases in White/other patients.
  • Exposure to IDV and TFV was associated with accelerated eGFR decline (4.6-fold and 3.7-fold, respectively).
  • Older age (≥50 years) and baseline eGFR were risk factors for CKD development with IDV or TFV exposure.

Conclusions:

  • Metabolic and vascular diseases contribute significantly to CKD burden in aging HIV patients.
  • Treatment with IDV or TFV is linked to a faster decline in renal function among HIV patients who develop CKD.
Abstract

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