6. Evaluation of early mortality in patients with advanced HIV disease in Vietnam using glomerular filtration rate estimated with MDRD equation

Vu Quoc Dat, Nguyen Le Hiep

Main Article Content

Abstract

According to the recommendations, if the creatinine test is routinely available, physicians should use the estimated glomerular filtration rate at baseline before initiating TDF regimens. In this retrospective observational cohort study. We enrolled patients of 18 years old and above, diagnosed with advanced HIV diseases between January 2021 to May 2022, from all ART clinics in 15 provinces in Vietnam. Renal function was assessed by the estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease (MDRD) equation. 6.0% (108/1787) had baseline eGFR < 60 ml/min/1.73m2. Factors associated with baseline renal impairment (eGFR < 60 ml/min/1.73m2) were gender (female) (OR = 4.07, 95%CI: 2.71 - 6.08), low hemoglobin (OR = 1.86, 95%CI: 1.01 - 3.22) and older age (OR = 1.07, 95%CI: 1.05 - 1.09). Mortality in patients with renal impairment at baseline was 11.5% (7/61), while the normal renal function group was 7.5% (99/1362). There is a need for assessment of renal function at baseline before ART initiation and regular monitoring of renal function for patients with HIV during follow-up.

Article Details

References

1. Mizushima D, Tanuma J, Kanaya F, et al. WHO antiretroviral therapy guidelines 2010 and impact of tenofovir on chronic kidney disease in Vietnamese HIV-infected patients. PloS one. 2013;8(11):e79885.
2. Ekrikpo UE, Kengne AP, Bello AK, et al. Chronic kidney disease in the global adult HIV-infected population: A systematic review and meta-analysis. PloS one. 2018;13(4):e0195443.
3. Gardner LI, Klein RS, Szczech LA, et al. Rates and risk factors for condition-specific hospitalizations in HIV-infected and uninfected women. J Acquir Immune Defic Syndr. 2003;34(3):320-30.
4. Ibrahim F, Hamzah L, Jones R, et al. Baseline kidney function as predictor of mortality and kidney disease progression in HIV-positive patients. American journal of kidney diseases: the official journal of the National Kidney Foundation. 2012;60(4):539-47.
5. Wyatt CM, Klotman PE, D’Agati VD. HIV-associated nephropathy: Clinical presentation, pathology, and epidemiology in the era of antiretroviral therapy. Semin Nephrol. 2008;28(6):513-22.
6. Alfano G, Cappelli G, Fontana F, Di Lullo L, Di Iorio B, Bellasi A, et al. Kidney Disease in HIV Infection. J Clin Med. 2019;8(8).
7. World Health O. Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. 2016 update ed. Geneva: World Health Organization; 2016 2016.
8. Bộ Y tế. Hướng dẫn Điều trị và chăm sóc HIV/AIDS (Ban hành kèm theo Quyết định số 5968/QĐ-BYT ngày 31/12/2021 của Bộ Y tế). 2021.
9. World Health Organization. HIV treatment: guidelines for managing advanced HIV disease and rapid initiation of antiretroviral therapy: policy brief. Geneva: World Health Organization; 2017. Contract No.: WHO/HIV/2017.18.
10. Romagnani P, Remuzzi G, Glassock R, et al. Chronic kidney disease. Nat Rev Dis Primers. 2017;3:17088.
11. Kabore NF, Poda A, Zoungrana J, Da O, Ciaffi L, Semde A, et al. Chronic kidney disease and HIV in the era of antiretroviral treatment: Findings from a 10-year cohort study in a west African setting. BMC Nephrol. 2019;20(1):155.
12. Zhao Y, Zhang M, Shi CX, et al. Renal Function in Chinese HIV-Positive Individuals following Initiation of Antiretroviral Therapy. PloS one. 2015;10(8):e0135462.
13. Juega-Marino J, Bonjoch A, Perez-Alvarez N, et al. Prevalence, evolution, and related risk factors of kidney disease among Spanish HIV-infected individuals. Medicine (Baltimore). 2017;96(37):e7421.
14. Adedeji TA, Adedeji NO, Adebisi SA, et al. Prevalence and Pattern of Chronic Kidney Disease in Antiretroviral-Naive Patients with HIV/AIDS. Journal of the International Association of Providers of AIDS Care. 2015;14(5):434-40.
15. Winston JA, Bruggeman LA, Ross MD, Jacobson J, Ross L, D’Agati VD, et al. Nephropathy and establishment of a renal reservoir of HIV type 1 during primary infection. The New England journal of medicine. 2001;344(26):1979-84.
16. Suzuki S, Nishijima T, Kawasaki Y, et al. Effect of Tenofovir Disoproxil Fumarate on Incidence of Chronic Kidney Disease and Rate of Estimated Glomerular Filtration Rate Decrement in HIV-1-Infected Treatment-Naive Asian Patients: Results from 12-Year Observational Cohort. AIDS Patient Care STDS. 2017;31(3):105-12.
17. Wyatt C, Klotman P. Overview of kidney disease in patients with HIV. Published online 2022. https://www.uptodate.com/contents/overview-of-kidney-disease-in-patients-with-hiv
18. Wyatt CM. Kidney Disease and HIV Infection. Top Antivir Med. 2017;25(1):13-16.
19. Mayor AM, Dworkin M, Quesada L, Ríos-Olivares E, Hunter-Mellado RF. The morbidity and mortality associated with kidney disease in an HIV-infected cohort in Puerto Rico. Ethn Dis. 2010;20(1 Suppl 1):163-167.
20. Wyatt CM, Arons RR, Klotman PE, Klotman ME. Acute renal failure in hospitalized patients with HIV: risk factors and impact on in-hospital mortality. AIDS Lond Engl. 2006;20(4):561-565. doi: 10.1097/01.aids.0000210610.52836.07.
21. Taborelli M, Suligoi B, Serraino D, et al. Increased kidney disease mortality among people with AIDS versus the general population: a population-based cohort study in Italy, 2006-2018. BMJ Open. 2022;12(12):e064970. doi: 10.1136/bmjopen-2022-064970.
22. Gallant JE, Parish MA, Keruly JC, et al. Changes in renal function associated with tenofovir disoproxil fumarate treatment, compared with nucleoside reverse-transcriptase inhibitor treatment. Clin Infect Dis. 2005;40(8):1194-8.
23. Tanaka H, Arai M, Tomoda Y, et al. Evaluation of renal adverse effects of combination anti-retroviral therapy including tenofovir in HIV-infected patients. J Pharm Pharm Sci. 2013;16(3):405-13.