Evaluation of glomerular filtration rate in HIV-1-infected patients before and after combined antiretroviral therapy exposure.

Evaluation of glomerular filtration rate in HIV-1-infected patients before and after combined antiretroviral therapy exposure.

MedLine Citation:	PMID: 20584091 Owner: NLM Status: In-Process
Abstract/OtherAbstract:	BACKGROUND: The prevalence and factors associated with an increased risk of renal dysfunction in HIV-infected patients receiving or not receiving antiretroviral therapy (ART) have been poorly evaluated in observational settings. METHODS: Patients in the ICONA Foundation cohort with at least two creatinine values available while still ART-naïve were enrolled in the study. A logistic regression analysis was performed to identify predictors of an estimated glomerular filtration rate (eGFR)<90 mL/min/1.73 m(2) at baseline. The incidence and predictors of a >20% reduction in eGFR from pre-combination ART (cART) levels (or a decrease from ≥90 to <90 mL/min/1.73 m(2) ) were evaluated by Poisson regression. RESULTS: A total of 1505 patients were included in the study; 363 (24%) had eGFR<90 mL/min/1.73 m(2) at baseline. Older patients [odds ratio (OR) 1.58 per 10 years older; P<0.00001], female patients (OR 2.41 vs. male patients; P<0.00001), those who had diabetes and/or hypertension (OR 2.36 vs. neither; P<0.03) and patients with higher baseline CD4 count (OR 1.06 per 100 cells/μL higher; P<0.03) showed a greater risk of eGFR<90 mL/min/1.73 m(2) . Ninety-six patients experienced an eGFR decrease of >20% from pre-cART levels (6.8 per 100 person-years). Older age [relative risk (RR) 1.41 per 10 years older; P=0.005], female gender (RR 2.25 vs. male; P=0.003) and current exposure to didanosine (ddI), tenofovir and protease inhibitors were the major determinants. CONCLUSIONS: We observed a relatively high rate of mild renal dysfunction in the absence of ART. In addition to traditional risk factors such as older age and diabetes/hypertension, female gender and current use of ddI, tenofovir and protease inhibitors were associated with a greater risk of decreased renal function as measured by eGFR.

Authors:	F Tordato; A Cozzi Lepri; P Cicconi; A De Luca; A Antinori; V Colangeli; A Castagna; P Nasta; N Ladisa; A Giacometti; A d'Arminio Monforte; A Gori;
Publication Detail:	Type: Journal Article; Research Support, Non-U.S. Gov't
Journal Detail:	Title: HIV medicine Volume: 12 ISSN: 1468-1293 ISO Abbreviation: HIV Med. Publication Date: 2011 Jan
Date Detail:	Created Date: 2010-12-06 Completed Date: - Revised Date: -
Medline Journal Info:	Nlm Unique ID: 100897392 Medline TA: HIV Med Country: England
Other Details:	Languages: eng Pagination: 4-13 Citation Subset: IM
Copyright Information:	© 2010 British HIV Association.
Affiliation:	Department of Medicine, Surgery and Dentistry, University of Milan, Milan, Italy. federica.tordato@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Investigator
Investigator/Affiliation:	A Ammassari / ; A Antinori / ; C Arici / ; C Balotta / ; P Bonfanti / ; M R Capobianchi / ; A Castagna / ; F Ceccherini-Silberstein / ; A Cozzi-Lepri / ; A d'Arminio Monforte / ; A De Luca / ; C Gervasoni / ; E Girardi / ; S Lo Caputo / ; R Murri / ; C Mussini / ; M Puoti / ; C Torti / ; M Montroni / ; G Scalise / ; M C Braschi / ; A Riva / ; U Tirelli / ; F Martellotta / ; G Pastore / ; N Ladisa / ; F Suter / ; C Arici / ; F Chiodo / ; V Colangeli / ; C Fiorini / ; O Coronado / ; G Carosi / ; G Cristini / ; C Torti / ; C Minardi / ; D Bertelli / ; T Quirino / ; P E Manconi / ; P Piano / ; E Pizzigallo / ; M D'Alessandro / ; F Ghinelli / ; L Sighinolfi / ; F Leoncini / ; F Mazzotta / ; M Pozzi / ; S Lo Caputo / ; B Grisorio / ; S Ferrara / ; G Pagano / ; G Cassola / ; A Alessandrini / ; R Piscopo / ; F Soscia / ; L Tacconi / ; A Orani / ; P Perini / ; F Chiodera / ; P Castelli / ; M Moroni / ; A Lazzarin / ; G Rizzardini / ; L Caggese / ; A d'Arminio Monforte / ; A Galli / ; S Merli / ; C Pastecchia / ; M C Moioli / ; R Esposito / ; C Mussini / ; N Abrescia / ; A Chirianni / ; M De Marco / ; R Viglietti / ; C Ferrari / ; P Pizzaferri / ; G Filice / ; R Bruno / ; G Magnani / ; M A Ursitti / ; M Arlotti / ; P Ortolani / ; R Cauda / ; A Antinori / ; G Antonucci / ; P Narciso / ; V Vullo / ; A De Luca / ; M Zaccarell / ; R Acinapura / ; P De Longis / ; M P Trotta / ; M Lichtner / ; F Carletti / ; M S Mura / ; M Mannazzu / ; P Caramello / ; G Di Perri / ; G C Orofino / ; M Sciandra / ; E Raise / ; F Ebo / ; G Pellizzer / ; D Buonfrate /
Comments/Corrections
Comment In:	HIV Med. 2011 Jan;12(1):1-3 [PMID: 21129144 ]

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