NDT Advance Access originally published online on June 16, 2007
Nephrology Dialysis Transplantation 2007 22(11):3186-3190; doi:10.1093/ndt/gfm350
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Prevalence of chronic kidney disease in Chinese HIV-infected patients
1Renal Unit, Queen Elizabeth Hospital, 2Renal Unit, Hong Kong Baptist Hospital and 3AIDS Clinical Service, Queen Elizabeth Hospital, Hong Kong, China
Correspondence and offprint requests to: Dr Chi Yuen Cheung, Department of Medicine, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong, China. Email: simoncycheung{at}gmail.com
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Abstract |
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Background. To evaluate the prevalence of chronic kidney disease (CKD) in Chinese HIV-infected population.
Methods. This was a cross-sectional point prevalence study. All Chinese HIV-infected patients who were followed up in a tertiary referral center in Hong Kong were recruited. Spot urine was saved for each patient to calculate urine protein-to-creatinine ratio (urine P/Cr). Those with urine P/Cr > 0.3 would have 24-h urine collection to determine the exact amount of proteinuria. Glomerular filtration rate (GFR) was estimated using MDRD formula. CKD was defined as GFR <60 ml/min/1.73 m2 and/or urine P/Cr > 0.3. Baseline demographic and clinical data were extracted from patients’ records.
Results. In total 322 patients were recruited. The mean age was 45.2 ± 11.7 years. The duration of follow up was 6.0 ± 4.0 years. There were 264 male and 58 female patients. The prevalence of hypertension, diabetes mellitus and CKD were 7.4%, 10.6% and 16.8%, respectively. Eighteen patients (5.6%) had GFR < 60 ml/min/1.73 m2 while 44 patients (13.7%) had spot urine P/Cr > 0.3. Among those with urine P/Cr > 0.3, 38 patients had 24-h urine collection. Using univariate analysis, CKD was found to be significantly (P < 0.05) associated with age, hypertension, diabetes, use of indinavir, lower CD4 count and peak viral load. Multivariate logistic regression revealed older age (P < 0.001), lower CD4 count (P = 0.02) and use of indinavir therapy (P = 0.04) were associated with development of CKD.
Conclusion. CKD is prevalent in Chinese HIV-infected patients. Patients with CKD were more likely to be older, associated with use of indinavir and CD4 nadir less than 100 cells/µl.
Keywords: chronic kidney disease; human immunodeficiency virus; proteinuria
Received for publication: 25.10.06
Accepted in revised form: 8. 5.07