Chronic kidney disease in patients infected with human immunodeficiency virus (HIV) in an urban cohort

Research output: Contribution to journalArticle

Rosbel M. Brito, Duc T. Nguyen, Justine R. Johnson, Eric J. Lai, Rochelle E. Castro, Angelina M. Albert, Ann S. Barnes, Edward A. Graviss, Wadi N. Suki

Background and objectives HIV-infected patients are at risk for developing chronic kidney disease (CKD), defined by estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m 2 . Our purpose was to understand the genesis of CKD in HIV patients from a large urban clinic in Houston, Texas, USA, and to characterize progression of CKD in the cohort. Design, setting, participants and measurements A retrospective cohort study (2012–2016) was conducted in all HIV-infected patients seen in a federally qualified community health center in Houston, Texas. CKD prevalence and its association with HIV viral load and CD4 count were determined. The association of the change in eGFR over time and comorbidities was assessed using linear mixed models. Results Of 3714 HIV-infected patients analyzed, 153 (4.1%) had CKD. The prevalence of CKD in the different racial groups was 5.4% White, 4.0% African American, 2.8% Hispanic/Latino and 3.2% Asian. There was no difference in the rate of decline in kidney function in White vs. African American HIV infected patients with CKD. Compared with non-CKD patients, CKD patients were older, had lived longer with HIV infection, had lower CD4 cell counts, higher proportions of hypertension, hyperlipidemia, and cerebrovascular disease, and had significantly higher rates of eGFR deterioration represented by a median decrease of 26.5% from first to last follow-up eGFR (versus 0% change). Linear mixed modeling identified older age, male gender, White race, longer time with HIV infection, hypertension, history of kidney stones, cerebrovascular disease, autoimmune disease, increased potassium and total cholesterol levels, and being treated with combination ART as associated with a worsening eGFR over time. Conclusion This study demonstrates a prevalence of CKD in HIV-infected patients of 4.1% and points to an important role for HIV medications and other common comorbidities in the genesis and progression of kidney disease. Importantly, CKD was not more prevalent in African Americans than in Whites, perhaps due to a low prevalence of IV drug abuse as inferred from the lower prevalence of HCV infection in this cohort.

Original languageEnglish (US)
Article numbere0215575
Pages (from-to)e0215575
JournalPloS one
Volume14
Issue number4
DOIs
StatePublished - Apr 17 2019

PMID: 30995263

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Chronic kidney disease in patients infected with human immunodeficiency virus (HIV) in an urban cohort. / Brito, Rosbel M.; Nguyen, Duc T.; Johnson, Justine R.; Lai, Eric J.; Castro, Rochelle E.; Albert, Angelina M.; Barnes, Ann S.; Graviss, Edward A.; Suki, Wadi N.

In: PloS one, Vol. 14, No. 4, e0215575, 17.04.2019, p. e0215575.

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Harvard

Brito, RM, Nguyen, DT, Johnson, JR, Lai, EJ, Castro, RE, Albert, AM, Barnes, AS, Graviss, EA & Suki, WN 2019, 'Chronic kidney disease in patients infected with human immunodeficiency virus (HIV) in an urban cohort' PloS one, vol. 14, no. 4, e0215575, pp. e0215575. https://doi.org/10.1371/journal.pone.0215575

APA

Brito, R. M., Nguyen, D. T., Johnson, J. R., Lai, E. J., Castro, R. E., Albert, A. M., ... Suki, W. N. (2019). Chronic kidney disease in patients infected with human immunodeficiency virus (HIV) in an urban cohort. PloS one, 14(4), e0215575. [e0215575]. https://doi.org/10.1371/journal.pone.0215575

Vancouver

Brito RM, Nguyen DT, Johnson JR, Lai EJ, Castro RE, Albert AM et al. Chronic kidney disease in patients infected with human immunodeficiency virus (HIV) in an urban cohort. PloS one. 2019 Apr 17;14(4):e0215575. e0215575. https://doi.org/10.1371/journal.pone.0215575

Author

Brito, Rosbel M. ; Nguyen, Duc T. ; Johnson, Justine R. ; Lai, Eric J. ; Castro, Rochelle E. ; Albert, Angelina M. ; Barnes, Ann S. ; Graviss, Edward A. ; Suki, Wadi N. / Chronic kidney disease in patients infected with human immunodeficiency virus (HIV) in an urban cohort. In: PloS one. 2019 ; Vol. 14, No. 4. pp. e0215575.

BibTeX

@article{7150c78172cd49dca28e635b3f8da805,
title = "Chronic kidney disease in patients infected with human immunodeficiency virus (HIV) in an urban cohort",
abstract = "Background and objectives HIV-infected patients are at risk for developing chronic kidney disease (CKD), defined by estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m 2 . Our purpose was to understand the genesis of CKD in HIV patients from a large urban clinic in Houston, Texas, USA, and to characterize progression of CKD in the cohort. Design, setting, participants and measurements A retrospective cohort study (2012–2016) was conducted in all HIV-infected patients seen in a federally qualified community health center in Houston, Texas. CKD prevalence and its association with HIV viral load and CD4 count were determined. The association of the change in eGFR over time and comorbidities was assessed using linear mixed models. Results Of 3714 HIV-infected patients analyzed, 153 (4.1{\%}) had CKD. The prevalence of CKD in the different racial groups was 5.4{\%} White, 4.0{\%} African American, 2.8{\%} Hispanic/Latino and 3.2{\%} Asian. There was no difference in the rate of decline in kidney function in White vs. African American HIV infected patients with CKD. Compared with non-CKD patients, CKD patients were older, had lived longer with HIV infection, had lower CD4 cell counts, higher proportions of hypertension, hyperlipidemia, and cerebrovascular disease, and had significantly higher rates of eGFR deterioration represented by a median decrease of 26.5{\%} from first to last follow-up eGFR (versus 0{\%} change). Linear mixed modeling identified older age, male gender, White race, longer time with HIV infection, hypertension, history of kidney stones, cerebrovascular disease, autoimmune disease, increased potassium and total cholesterol levels, and being treated with combination ART as associated with a worsening eGFR over time. Conclusion This study demonstrates a prevalence of CKD in HIV-infected patients of 4.1{\%} and points to an important role for HIV medications and other common comorbidities in the genesis and progression of kidney disease. Importantly, CKD was not more prevalent in African Americans than in Whites, perhaps due to a low prevalence of IV drug abuse as inferred from the lower prevalence of HCV infection in this cohort.",
author = "Brito, {Rosbel M.} and Nguyen, {Duc T.} and Johnson, {Justine R.} and Lai, {Eric J.} and Castro, {Rochelle E.} and Albert, {Angelina M.} and Barnes, {Ann S.} and Graviss, {Edward A.} and Suki, {Wadi N.}",
year = "2019",
month = "4",
day = "17",
doi = "10.1371/journal.pone.0215575",
language = "English (US)",
volume = "14",
pages = "e0215575",
journal = "PLoS ONE",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "4",

}

RIS

TY - JOUR

T1 - Chronic kidney disease in patients infected with human immunodeficiency virus (HIV) in an urban cohort

AU - Brito, Rosbel M.

AU - Nguyen, Duc T.

AU - Johnson, Justine R.

AU - Lai, Eric J.

AU - Castro, Rochelle E.

AU - Albert, Angelina M.

AU - Barnes, Ann S.

AU - Graviss, Edward A.

AU - Suki, Wadi N.

PY - 2019/4/17

Y1 - 2019/4/17

N2 - Background and objectives HIV-infected patients are at risk for developing chronic kidney disease (CKD), defined by estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m 2 . Our purpose was to understand the genesis of CKD in HIV patients from a large urban clinic in Houston, Texas, USA, and to characterize progression of CKD in the cohort. Design, setting, participants and measurements A retrospective cohort study (2012–2016) was conducted in all HIV-infected patients seen in a federally qualified community health center in Houston, Texas. CKD prevalence and its association with HIV viral load and CD4 count were determined. The association of the change in eGFR over time and comorbidities was assessed using linear mixed models. Results Of 3714 HIV-infected patients analyzed, 153 (4.1%) had CKD. The prevalence of CKD in the different racial groups was 5.4% White, 4.0% African American, 2.8% Hispanic/Latino and 3.2% Asian. There was no difference in the rate of decline in kidney function in White vs. African American HIV infected patients with CKD. Compared with non-CKD patients, CKD patients were older, had lived longer with HIV infection, had lower CD4 cell counts, higher proportions of hypertension, hyperlipidemia, and cerebrovascular disease, and had significantly higher rates of eGFR deterioration represented by a median decrease of 26.5% from first to last follow-up eGFR (versus 0% change). Linear mixed modeling identified older age, male gender, White race, longer time with HIV infection, hypertension, history of kidney stones, cerebrovascular disease, autoimmune disease, increased potassium and total cholesterol levels, and being treated with combination ART as associated with a worsening eGFR over time. Conclusion This study demonstrates a prevalence of CKD in HIV-infected patients of 4.1% and points to an important role for HIV medications and other common comorbidities in the genesis and progression of kidney disease. Importantly, CKD was not more prevalent in African Americans than in Whites, perhaps due to a low prevalence of IV drug abuse as inferred from the lower prevalence of HCV infection in this cohort.

AB - Background and objectives HIV-infected patients are at risk for developing chronic kidney disease (CKD), defined by estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m 2 . Our purpose was to understand the genesis of CKD in HIV patients from a large urban clinic in Houston, Texas, USA, and to characterize progression of CKD in the cohort. Design, setting, participants and measurements A retrospective cohort study (2012–2016) was conducted in all HIV-infected patients seen in a federally qualified community health center in Houston, Texas. CKD prevalence and its association with HIV viral load and CD4 count were determined. The association of the change in eGFR over time and comorbidities was assessed using linear mixed models. Results Of 3714 HIV-infected patients analyzed, 153 (4.1%) had CKD. The prevalence of CKD in the different racial groups was 5.4% White, 4.0% African American, 2.8% Hispanic/Latino and 3.2% Asian. There was no difference in the rate of decline in kidney function in White vs. African American HIV infected patients with CKD. Compared with non-CKD patients, CKD patients were older, had lived longer with HIV infection, had lower CD4 cell counts, higher proportions of hypertension, hyperlipidemia, and cerebrovascular disease, and had significantly higher rates of eGFR deterioration represented by a median decrease of 26.5% from first to last follow-up eGFR (versus 0% change). Linear mixed modeling identified older age, male gender, White race, longer time with HIV infection, hypertension, history of kidney stones, cerebrovascular disease, autoimmune disease, increased potassium and total cholesterol levels, and being treated with combination ART as associated with a worsening eGFR over time. Conclusion This study demonstrates a prevalence of CKD in HIV-infected patients of 4.1% and points to an important role for HIV medications and other common comorbidities in the genesis and progression of kidney disease. Importantly, CKD was not more prevalent in African Americans than in Whites, perhaps due to a low prevalence of IV drug abuse as inferred from the lower prevalence of HCV infection in this cohort.

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DO - 10.1371/journal.pone.0215575

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ID: 47595764