PT  - JOURNAL ARTICLE
AU  - Flandre, Philippe
AU  - Pugliese, Pascal
AU  - Cuzin, Lise
AU  - Bagnis, Corinne Isnard
AU  - Tack, Ivan
AU  - Cabié, André
AU  - Poizot-Martin, Isabelle
AU  - Katlama, Christine
AU  - Brunet-François, Cécile
AU  - Yazdanpanah, Yazdan
AU  - Dellamonica, Pierre
TI  - Risk Factors of Chronic Kidney Disease in HIV-infected Patients
AID  - 10.2215/CJN.09191010
DP  - 2011 Jul 01
TA  - Clinical Journal of the American Society of Nephrology
PG  - 1700--1707
VI  - 6
IP  - 7
4099  - http://cjasn.asnjournals.org/content/6/7/1700.short
4100  - http://cjasn.asnjournals.org/content/6/7/1700.full
SO  - CLIN J AM SOC NEPHROL2011 Jul 01; 6
AB  - Background and objectives The main aim of this study was determining the risk factors of chronic kidney disease (CKD) in HIV-1-infected patients. Design, setting, participants, & measurements Patients were followed from seven large HIV reference centers in France that maintain prospective databases on HIV-1-infected patients. The main outcome was the time to CKD defined as two consecutive measures of estimated GFR ≤60 ml/min per 1.73 m2 over ≥3 months. A Cox's model with delayed entry was used to search predictive factors of time to CKD. Results From 1993 to 2006, 349 out of 7378 patients were found to have CKD. Of these, 166 had hypertension, 33 had diabetes, and 26 were antiretroviral therapy–naïve. Occurrence of acute kidney injury (hazard ratio [HR] = 2.40) and hypertension (HR = 2.39) were strongly associated with an increased risk of CKD. Patients with a durable level of CD4 count >200 cells/mm3 had a lower risk of CKD (HR = 0.63). Recent exposure to indinavir (HR = 2.03), totenofovir (HR = 1.55), and abacavir (HR = 1.37) were associated with an increased risk of CKD. Past exposure to tenofovir was also associated with an increased risk of CKD (HR = 2.23), and a trend toward significance was observed for past exposure to indinavir (HR = 1.28). Conclusions CKD was not rare in HIV-infected patients and occurs preferentially in HIV-infected patients exposed to certain ARVs, specifically abacavir, indinavir and tenofovir. This requires closer monitoring of renal function in patients exposed to one of these drugs.