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Estimated glomerular filtration rate, chronic kidney disease and antiretroviral drug use in HIV-positive patients

Objectives: Chronic kidney disease (CKD) in HIV-positive persons might be caused by both HIV and traditional or non-HIV-related factors. Our objective was to investigate long-term exposure to specific antiretroviral drugs and CKD. Design: A cohort study including 6843 HIV-positive persons with at le... Full description

Journal Title: AIDS (London) 2010, Vol.24 (11), p.1667-1678
Main Author: Mocroft, Amanda
Other Authors: Kirk, Ole , Reiss, Peter , de Wit, Stephane , Sedlacek, Dalibor , Beniowski, Marek , Gatell, Jose , Phillips, Anew N , Ledergerber, Bruno , Lundgren, Jens D
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Hagerstown, MD: Lippincott Williams & Wilkins
ID: ISSN: 0269-9370
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title: Estimated glomerular filtration rate, chronic kidney disease and antiretroviral drug use in HIV-positive patients
format: Article
creator:
  • Mocroft, Amanda
  • Kirk, Ole
  • Reiss, Peter
  • de Wit, Stephane
  • Sedlacek, Dalibor
  • Beniowski, Marek
  • Gatell, Jose
  • Phillips, Anew N
  • Ledergerber, Bruno
  • Lundgren, Jens D
subjects:
  • 610 Medicine & health
  • Adenine
  • Adenine - adverse effects
  • Adenine - analogs & derivatives
  • Adult
  • AIDS/HIV
  • Anti
  • Anti-HIV Agents - adverse effects
  • Atazanavir Sulfate
  • Biological and medical sciences
  • Chronic
  • Clinic for Infectious Diseases
  • Disease Progression
  • Epidemiologic Methods
  • Female
  • Glomerular Filtration Rate
  • Glomerular Filtration Rate - drug effects
  • Glomerulonephritis
  • HIV Agents
  • HIV Seropositivity
  • HIV Seropositivity - drug therapy
  • HIV Seropositivity - epidemiology
  • HIV Seropositivity - physiopathology
  • HIV-1
  • Human immunodeficiency virus
  • Human viral diseases
  • Humans
  • Indinavir
  • Indinavir - adverse effects
  • Infectious diseases
  • Kidney Failure
  • Kidney Failure, Chronic - chemically induced
  • Kidney Failure, Chronic - epidemiology
  • Kidney Failure, Chronic - physiopathology
  • Kidneys
  • Male
  • male genital diseases
  • Medical sciences
  • Middle Aged
  • Nephrology. Urinary tract diseases
  • Nephropathies. Renovascular diseases. Renal failure
  • Oligopeptides
  • Oligopeptides - adverse effects
  • Organophosphonates
  • Organophosphonates - adverse effects
  • Pyridines
  • Pyridines - adverse effects
  • Reverse Transcriptase Inhibitors
  • Reverse Transcriptase Inhibitors - adverse effects
  • Tenofovir
  • Urinary system involvement in other diseases. Miscellaneous
  • urologic
  • Viral diseases
  • Viral diseases of the lymphoid tissue and the blood. Aids
  • virus diseases
ispartof: AIDS (London), 2010, Vol.24 (11), p.1667-1678
description: Objectives: Chronic kidney disease (CKD) in HIV-positive persons might be caused by both HIV and traditional or non-HIV-related factors. Our objective was to investigate long-term exposure to specific antiretroviral drugs and CKD. Design: A cohort study including 6843 HIV-positive persons with at least three serum creatinine measurements and corresponding body weight measurements from 2004 onwards. Methods: CKD was defined as either confirmed (two measurements >= 3 months apart) estimated glomerular filtration rate (eGFR) of 60 ml/min per 1.73 m(2) or below for persons with baseline eGFR of above 60 ml/min per 1.73 m(2) or confirmed 25% decline in eGFR for persons with baseline eGFR of 60 ml/min per 1.73 m(2) or less, using the Cockcroft-Gault formula. Poisson regression was used to determine factors associated with CKD. Results: Two hundred and twenty-five (3.3%) persons progressed to CKD during 21 482 person-years follow-up, an incidence of 1.05 per 100 person-years follow-up [95% confidence interval (CI) 0.91-1.18]; median follow-up was 3.7 years (interquartile range 2.8-5.7). After adjustment for traditional factors associated with CKD and other confounding variables, increasing cumulative exposure to tenofovir [incidence rate ratio (IRR) per year 1.16, 95% CI 1.06-1.25, P
language: eng
source:
identifier: ISSN: 0269-9370
fulltext: no_fulltext
issn:
  • 0269-9370
  • 1473-5571
url: Link


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titleEstimated glomerular filtration rate, chronic kidney disease and antiretroviral drug use in HIV-positive patients
creatorMocroft, Amanda ; Kirk, Ole ; Reiss, Peter ; de Wit, Stephane ; Sedlacek, Dalibor ; Beniowski, Marek ; Gatell, Jose ; Phillips, Anew N ; Ledergerber, Bruno ; Lundgren, Jens D
creatorcontribMocroft, Amanda ; Kirk, Ole ; Reiss, Peter ; de Wit, Stephane ; Sedlacek, Dalibor ; Beniowski, Marek ; Gatell, Jose ; Phillips, Anew N ; Ledergerber, Bruno ; Lundgren, Jens D ; EuroSIDA Study Group
descriptionObjectives: Chronic kidney disease (CKD) in HIV-positive persons might be caused by both HIV and traditional or non-HIV-related factors. Our objective was to investigate long-term exposure to specific antiretroviral drugs and CKD. Design: A cohort study including 6843 HIV-positive persons with at least three serum creatinine measurements and corresponding body weight measurements from 2004 onwards. Methods: CKD was defined as either confirmed (two measurements >= 3 months apart) estimated glomerular filtration rate (eGFR) of 60 ml/min per 1.73 m(2) or below for persons with baseline eGFR of above 60 ml/min per 1.73 m(2) or confirmed 25% decline in eGFR for persons with baseline eGFR of 60 ml/min per 1.73 m(2) or less, using the Cockcroft-Gault formula. Poisson regression was used to determine factors associated with CKD. Results: Two hundred and twenty-five (3.3%) persons progressed to CKD during 21 482 person-years follow-up, an incidence of 1.05 per 100 person-years follow-up [95% confidence interval (CI) 0.91-1.18]; median follow-up was 3.7 years (interquartile range 2.8-5.7). After adjustment for traditional factors associated with CKD and other confounding variables, increasing cumulative exposure to tenofovir [incidence rate ratio (IRR) per year 1.16, 95% CI 1.06-1.25, P <0.0001), indinavir (IRR 1.12, 95% CI 1.06-1.18, P <0.0001), atazanavir (IRR 1.21, 95% CI 1.09-1.34, P=0.0003) and lopinavir/r (IRR 1.08, 95% CI 1.01-1.16, P=0.030) were associated with a significantly increased rate of CKD. Consistent results were observed in wide-ranging sensitivity analyses, although of marginal statistical significance for lopinavir/r. No other antiretroviral dugs were associated with increased incidence of CKD. Conclusion: In this nonrandomized large cohort, increasing exposure to tenofovir was associated with a higher incidence of CKD, as was true for indinavir and atazanavir, whereas the results for lopinavir/r were less clear. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins
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languageeng
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subject610 Medicine & health ; Adenine ; Adenine - adverse effects ; Adenine - analogs & derivatives ; Adult ; AIDS/HIV ; Anti ; Anti-HIV Agents - adverse effects ; Atazanavir Sulfate ; Biological and medical sciences ; Chronic ; Clinic for Infectious Diseases ; Disease Progression ; Epidemiologic Methods ; Female ; Glomerular Filtration Rate ; Glomerular Filtration Rate - drug effects ; Glomerulonephritis ; HIV Agents ; HIV Seropositivity ; HIV Seropositivity - drug therapy ; HIV Seropositivity - epidemiology ; HIV Seropositivity - physiopathology ; HIV-1 ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Indinavir ; Indinavir - adverse effects ; Infectious diseases ; Kidney Failure ; Kidney Failure, Chronic - chemically induced ; Kidney Failure, Chronic - epidemiology ; Kidney Failure, Chronic - physiopathology ; Kidneys ; Male ; male genital diseases ; Medical sciences ; Middle Aged ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; Oligopeptides ; Oligopeptides - adverse effects ; Organophosphonates ; Organophosphonates - adverse effects ; Pyridines ; Pyridines - adverse effects ; Reverse Transcriptase Inhibitors ; Reverse Transcriptase Inhibitors - adverse effects ; Tenofovir ; Urinary system involvement in other diseases. Miscellaneous ; urologic ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; virus diseases
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1Kirk, Ole
2Reiss, Peter
3de Wit, Stephane
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5Beniowski, Marek
6Gatell, Jose
7Phillips, Anew N
8Ledergerber, Bruno
9Lundgren, Jens D
10EuroSIDA Study Group
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0Estimated glomerular filtration rate, chronic kidney disease and antiretroviral drug use in HIV-positive patients
1AIDS (London)
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descriptionObjectives: Chronic kidney disease (CKD) in HIV-positive persons might be caused by both HIV and traditional or non-HIV-related factors. Our objective was to investigate long-term exposure to specific antiretroviral drugs and CKD. Design: A cohort study including 6843 HIV-positive persons with at least three serum creatinine measurements and corresponding body weight measurements from 2004 onwards. Methods: CKD was defined as either confirmed (two measurements >= 3 months apart) estimated glomerular filtration rate (eGFR) of 60 ml/min per 1.73 m(2) or below for persons with baseline eGFR of above 60 ml/min per 1.73 m(2) or confirmed 25% decline in eGFR for persons with baseline eGFR of 60 ml/min per 1.73 m(2) or less, using the Cockcroft-Gault formula. Poisson regression was used to determine factors associated with CKD. Results: Two hundred and twenty-five (3.3%) persons progressed to CKD during 21 482 person-years follow-up, an incidence of 1.05 per 100 person-years follow-up [95% confidence interval (CI) 0.91-1.18]; median follow-up was 3.7 years (interquartile range 2.8-5.7). After adjustment for traditional factors associated with CKD and other confounding variables, increasing cumulative exposure to tenofovir [incidence rate ratio (IRR) per year 1.16, 95% CI 1.06-1.25, P <0.0001), indinavir (IRR 1.12, 95% CI 1.06-1.18, P <0.0001), atazanavir (IRR 1.21, 95% CI 1.09-1.34, P=0.0003) and lopinavir/r (IRR 1.08, 95% CI 1.01-1.16, P=0.030) were associated with a significantly increased rate of CKD. Consistent results were observed in wide-ranging sensitivity analyses, although of marginal statistical significance for lopinavir/r. No other antiretroviral dugs were associated with increased incidence of CKD. Conclusion: In this nonrandomized large cohort, increasing exposure to tenofovir was associated with a higher incidence of CKD, as was true for indinavir and atazanavir, whereas the results for lopinavir/r were less clear. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins
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1Adenine
2Adenine - adverse effects
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11Clinic for Infectious Diseases
12Disease Progression
13Epidemiologic Methods
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15Glomerular Filtration Rate
16Glomerular Filtration Rate - drug effects
17Glomerulonephritis
18HIV Agents
19HIV Seropositivity
20HIV Seropositivity - drug therapy
21HIV Seropositivity - epidemiology
22HIV Seropositivity - physiopathology
23HIV-1
24Human immunodeficiency virus
25Human viral diseases
26Humans
27Indinavir
28Indinavir - adverse effects
29Infectious diseases
30Kidney Failure
31Kidney Failure, Chronic - chemically induced
32Kidney Failure, Chronic - epidemiology
33Kidney Failure, Chronic - physiopathology
34Kidneys
35Male
36male genital diseases
37Medical sciences
38Middle Aged
39Nephrology. Urinary tract diseases
40Nephropathies. Renovascular diseases. Renal failure
41Oligopeptides
42Oligopeptides - adverse effects
43Organophosphonates
44Organophosphonates - adverse effects
45Pyridines
46Pyridines - adverse effects
47Reverse Transcriptase Inhibitors
48Reverse Transcriptase Inhibitors - adverse effects
49Tenofovir
50Urinary system involvement in other diseases. Miscellaneous
51urologic
52Viral diseases
53Viral diseases of the lymphoid tissue and the blood. Aids
54virus diseases
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titleEstimated glomerular filtration rate, chronic kidney disease and antiretroviral drug use in HIV-positive patients
authorMocroft, Amanda ; Kirk, Ole ; Reiss, Peter ; de Wit, Stephane ; Sedlacek, Dalibor ; Beniowski, Marek ; Gatell, Jose ; Phillips, Anew N ; Ledergerber, Bruno ; Lundgren, Jens D
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1Adenine
2Adenine - adverse effects
3Adenine - analogs & derivatives
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5AIDS/HIV
6Anti
7Anti-HIV Agents - adverse effects
8Atazanavir Sulfate
9Biological and medical sciences
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11Clinic for Infectious Diseases
12Disease Progression
13Epidemiologic Methods
14Female
15Glomerular Filtration Rate
16Glomerular Filtration Rate - drug effects
17Glomerulonephritis
18HIV Agents
19HIV Seropositivity
20HIV Seropositivity - drug therapy
21HIV Seropositivity - epidemiology
22HIV Seropositivity - physiopathology
23HIV-1
24Human immunodeficiency virus
25Human viral diseases
26Humans
27Indinavir
28Indinavir - adverse effects
29Infectious diseases
30Kidney Failure
31Kidney Failure, Chronic - chemically induced
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33Kidney Failure, Chronic - physiopathology
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35Male
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38Middle Aged
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45Pyridines
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47Reverse Transcriptase Inhibitors
48Reverse Transcriptase Inhibitors - adverse effects
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volume24
issue11
spage1667
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pages1667-1678
issn0269-9370
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abstractObjectives: Chronic kidney disease (CKD) in HIV-positive persons might be caused by both HIV and traditional or non-HIV-related factors. Our objective was to investigate long-term exposure to specific antiretroviral drugs and CKD. Design: A cohort study including 6843 HIV-positive persons with at least three serum creatinine measurements and corresponding body weight measurements from 2004 onwards. Methods: CKD was defined as either confirmed (two measurements >= 3 months apart) estimated glomerular filtration rate (eGFR) of 60 ml/min per 1.73 m(2) or below for persons with baseline eGFR of above 60 ml/min per 1.73 m(2) or confirmed 25% decline in eGFR for persons with baseline eGFR of 60 ml/min per 1.73 m(2) or less, using the Cockcroft-Gault formula. Poisson regression was used to determine factors associated with CKD. Results: Two hundred and twenty-five (3.3%) persons progressed to CKD during 21 482 person-years follow-up, an incidence of 1.05 per 100 person-years follow-up [95% confidence interval (CI) 0.91-1.18]; median follow-up was 3.7 years (interquartile range 2.8-5.7). After adjustment for traditional factors associated with CKD and other confounding variables, increasing cumulative exposure to tenofovir [incidence rate ratio (IRR) per year 1.16, 95% CI 1.06-1.25, P <0.0001), indinavir (IRR 1.12, 95% CI 1.06-1.18, P <0.0001), atazanavir (IRR 1.21, 95% CI 1.09-1.34, P=0.0003) and lopinavir/r (IRR 1.08, 95% CI 1.01-1.16, P=0.030) were associated with a significantly increased rate of CKD. Consistent results were observed in wide-ranging sensitivity analyses, although of marginal statistical significance for lopinavir/r. No other antiretroviral dugs were associated with increased incidence of CKD. Conclusion: In this nonrandomized large cohort, increasing exposure to tenofovir was associated with a higher incidence of CKD, as was true for indinavir and atazanavir, whereas the results for lopinavir/r were less clear. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins
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pmid20523203
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