Factors associated to chronic kidney disease in people living with HIV/AIDS

Area of Science:

• Nephrology
• Infectious Diseases
• Epidemiology

Background:

• Chronic kidney disease (CKD) is a significant comorbidity in people living with HIV (PLHIV).
• Identifying CKD risk factors in PLHIV is crucial for effective management and prevention strategies.
• Previous studies suggest various factors contribute to CKD in this population, but specific associations require further investigation.

Purpose of the Study:

• To analyze the factors associated with chronic kidney disease in people living with HIV (PLHIV).
• To identify specific risk and protective factors for CKD in a cohort of PLHIV in Brazil.
• To inform clinical practice and public health interventions for PLHIV at risk of renal dysfunction.

Main Methods:

• A paired case-control study design was employed, including 17 cases and 68 controls (4 controls per case).
• Data were collected from medical records of PLHIV attending a specialized care service in Southeastern Brazil.
• Statistical analyses included Pearson's chi-square test, Fisher's exact test, and logistic regression to determine Odds Ratios (OR) and 95% Confidence Intervals (CI).

Main Results:

• Systemic Arterial Hypertension was significantly associated with CKD in PLHIV [OR=5.8, p=0.001].
• Use of nephrotoxic antiretrovirals in previous therapeutic regimens was also linked to increased CKD risk [OR=3.3, p=0.028].
• Age below 40 years was identified as a protective factor against CKD [OR=0.122, p=0.022].

Conclusions:

• PLHIV exhibit multi-factorial exposure associated with chronic kidney disease.
• Identifying hypertension and nephrotoxic antiretroviral use as key risk factors aids in early detection and intervention.
• Knowledge of these factors supports clinical decision-making for health professionals managing PLHIV, aiming to prevent or manage renal dysfunction.