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

Amanda Mocroft; Ole Kirk; Peter Reiss; Stephane De Wit; Dalibor Sedlacek; Marek Beniowski; Jose Gatell; Andrew N. Phillips; Bruno Ledergerber; Jens D. Lundgren; M. Losso; C. Elias; N. Vetter; R. Zangerle; I. Karpov; A. Vassilenko; V. M. Mitsura; O. Suetnov; N. Clumeck; B. Poll; R. Colebunders; L. Vandekerckhove; V. Hadziosmanovic; K. Kostov; J. Begovac; L. Machala; H. Rozsypal; J. Nielsen; G. Kronborg; T. Benfield; M. Larsen; J. Gerstoft; T. Katzenstein; A. B. Hansen; P. Skinhøj; C. Pedersen; L. Oestergaard; K. Zilmer; J. Smidt; M. Ristola; C. Katlama; J. P. Viard; P. M. Girard; J. M. Livrozet; P. Vanhems; C. Pradier; F. Dabis; D. Neau; J. Rockstroh; R. Schmidt; J. van Lunzen; O. Degen; H. J. Stellbrink; S. Staszewski; J. Bogner; G. Fätkenheuer; J. Kosmidis; P. Gargalianos; G. Xylomenos; J. Perdios; G. Panos; A. Filandras; E. Karabatsaki; H. Sambatakou; D. Banhegyi; F. Mulcahy; I. Yust; D. Turner; M. Burke; S. Pollack; G. Hassoun; S. Maayan; A. Chiesi; R. Esposito; I. Mazeu; C. Mussini; C. Arici; R. Pristera; F. Mazzotta; A. Gabbuti; V. Vullo; M. Lichtner; A. Chirianni; E. Montesarchio; M. Gargiulo; G. Antonucci; F. Iacomi; P. Narciso; C. Vlassi; M. Zaccarelli; A. Lazzarin; R. Finazzi; M. Galli; A. Ridolfo; A. d'Arminio Monforte; B. Rozentale; P. Aldins; S. Chaplinskas; R. Hemmer; T. Staub; J. Bruun; A. Maeland; V. Ormaasen; B. Knysz; J. Gasiorowski; A. Horban; E. Bakowska; D. Prokopowicz; R. Flisiak; A. Boron-Kaczmarska; M. Pynka; E. Mularska; H. Trocha; E. Jablonowska; E. Malolepsza; K. Wojcik; F. Antunes; E. Valadas; K. Mansinho; F. Maltez; D. Duiculescu; V. Babes; A. Rakhmanova; E. Vinogradova; D. Jevtovic; M. Mokrás; D. Staneková; J. Tomazic; J. González-Lahoz; V. Soriano; L. Martin-Carbonero; P. Labarga; S. Moreno; B. Clotet; A. Jou; R. Paredes; C. Tural; J. Puig; I. Bravo; J. M. Miró; P. Domingo; M. Gutierrez; G. Mateo; M. A. Sambeat; A. Karlsson; P. O. Persson; L. Flamholc; R. Weber; P. Francioli; M. Cavassini; B. Hirschel; E. Boffi; H. Furrer; M. Battegay; L. Elzi; E. Kravchenko; N. Chentsova; G. Kutsyna; S. Servitskiy; S. Antoniak; M. Krasnov; S. Barton; A. M. Johnson; D. Mercey; M. A. Johnson; M. Murphy; J. Weber; G. Scullard; M. Fisher; C. Leen; B. Gazzard; A. D'Arminio Montforte; N. Friis-Møller; A. Cozzi-Lepri; W. Bannister; M. Ellefson; A. Borch; D. Podlekareva; J. Kjaer; L. Peters; J. Reekie; J. Kowalska

doi:10.1097/QAD.0b013e328339fe53

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

Amanda Mocroft^*, Ole Kirk, Peter Reiss, Stephane De Wit, Dalibor Sedlacek, Marek Beniowski, Jose Gatell, Andrew N. Phillips, Bruno Ledergerber, Jens D. Lundgren, M. Losso, C. Elias, N. Vetter, R. Zangerle, I. Karpov, A. Vassilenko, V. M. Mitsura, O. Suetnov, N. Clumeck, B. PollR. Colebunders, L. Vandekerckhove, V. Hadziosmanovic, K. Kostov, J. Begovac, L. Machala, H. Rozsypal, J. Nielsen, G. Kronborg, T. Benfield, M. Larsen, J. Gerstoft, T. Katzenstein, A. B. Hansen, P. Skinhøj, C. Pedersen, L. Oestergaard, K. Zilmer, J. Smidt, M. Ristola, C. Katlama, J. P. Viard, P. M. Girard, J. M. Livrozet, P. Vanhems, C. Pradier, F. Dabis, D. Neau, J. Rockstroh, R. Schmidt, J. van Lunzen, O. Degen, H. J. Stellbrink, S. Staszewski, J. Bogner, G. Fätkenheuer, J. Kosmidis, P. Gargalianos, G. Xylomenos, J. Perdios, G. Panos, A. Filandras, E. Karabatsaki, H. Sambatakou, D. Banhegyi, F. Mulcahy, I. Yust, D. Turner, M. Burke, S. Pollack, G. Hassoun, S. Maayan, A. Chiesi, R. Esposito, I. Mazeu, C. Mussini, C. Arici, R. Pristera, F. Mazzotta, A. Gabbuti, V. Vullo, M. Lichtner, A. Chirianni, E. Montesarchio, M. Gargiulo, G. Antonucci, F. Iacomi, P. Narciso, C. Vlassi, M. Zaccarelli, A. Lazzarin, R. Finazzi, M. Galli, A. Ridolfo, A. d'Arminio Monforte, B. Rozentale, P. Aldins, S. Chaplinskas, R. Hemmer, T. Staub, J. Bruun, A. Maeland, V. Ormaasen, B. Knysz, J. Gasiorowski, A. Horban, E. Bakowska, D. Prokopowicz, R. Flisiak, A. Boron-Kaczmarska, M. Pynka, E. Mularska, H. Trocha, E. Jablonowska, E. Malolepsza, K. Wojcik, F. Antunes, E. Valadas, K. Mansinho, F. Maltez, D. Duiculescu, V. Babes, A. Rakhmanova, E. Vinogradova, D. Jevtovic, M. Mokrás, D. Staneková, J. Tomazic, J. González-Lahoz, V. Soriano, L. Martin-Carbonero, P. Labarga, S. Moreno, B. Clotet, A. Jou, R. Paredes, C. Tural, J. Puig, I. Bravo, J. M. Miró, P. Domingo, M. Gutierrez, G. Mateo, M. A. Sambeat, A. Karlsson, P. O. Persson, L. Flamholc, R. Weber, P. Francioli, M. Cavassini, B. Hirschel, E. Boffi, H. Furrer, M. Battegay, L. Elzi, E. Kravchenko, N. Chentsova, G. Kutsyna, S. Servitskiy, S. Antoniak, M. Krasnov, S. Barton, A. M. Johnson, D. Mercey, M. A. Johnson, M. Murphy, J. Weber, G. Scullard, M. Fisher, C. Leen, B. Gazzard, A. D'Arminio Montforte, N. Friis-Møller, A. Cozzi-Lepri, W. Bannister, M. Ellefson, A. Borch, D. Podlekareva, J. Kjaer, L. Peters, J. Reekie, J. Kowalska

^*Corresponding author for this work

Clinical Departments

Research output: Contribution to journal › Article › peer-review

357 Scopus citations

Abstract

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 or below for persons with baseline eGFR of above 60 ml/min per 1.73 m or confirmed 25% decline in eGFR for persons with baseline eGFR of 60 ml/min per 1.73 m 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.

Original language	English
Pages (from-to)	1667-1678
Number of pages	12
Journal	AIDS
Volume	24
Issue number	11
DOIs	https://doi.org/10.1097/QAD.0b013e328339fe53
State	Published - 17 Jul 2010

Keywords

antiretroviral drugs
chronic kidney disease
estimated glomerular filtration rate

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1097/QAD.0b013e328339fe53

Cite this

Mocroft, A., Kirk, O., Reiss, P., De Wit, S., Sedlacek, D., Beniowski, M., Gatell, J., Phillips, A. N., Ledergerber, B., Lundgren, J. D., Losso, M., Elias, C., Vetter, N., Zangerle, R., Karpov, I., Vassilenko, A., Mitsura, V. M., Suetnov, O., Clumeck, N., ... Kowalska, J. (2010). Estimated glomerular filtration rate, chronic kidney disease and antiretroviral drug use in HIV-positive patients. AIDS, 24(11), 1667-1678. https://doi.org/10.1097/QAD.0b013e328339fe53

@article{40952e9460424903ba1b2f57d204baed,

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

abstract = "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 or below for persons with baseline eGFR of above 60 ml/min per 1.73 m or confirmed 25% decline in eGFR for persons with baseline eGFR of 60 ml/min per 1.73 m 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.",

keywords = "antiretroviral drugs, chronic kidney disease, estimated glomerular filtration rate",

author = "Amanda Mocroft and Ole Kirk and Peter Reiss and {De Wit}, Stephane and Dalibor Sedlacek and Marek Beniowski and Jose Gatell and Phillips, {Andrew N.} and Bruno Ledergerber and Lundgren, {Jens D.} and M. Losso and C. Elias and N. Vetter and R. Zangerle and I. Karpov and A. Vassilenko and Mitsura, {V. M.} and O. Suetnov and N. Clumeck and B. Poll and R. Colebunders and L. Vandekerckhove and V. Hadziosmanovic and K. Kostov and J. Begovac and L. Machala and H. Rozsypal and J. Nielsen and G. Kronborg and T. Benfield and M. Larsen and J. Gerstoft and T. Katzenstein and Hansen, {A. B.} and P. Skinh{\o}j and C. Pedersen and L. Oestergaard and K. Zilmer and J. Smidt and M. Ristola and C. Katlama and Viard, {J. P.} and Girard, {P. M.} and Livrozet, {J. M.} and P. Vanhems and C. Pradier and F. Dabis and D. Neau and J. Rockstroh and R. Schmidt and {van Lunzen}, J. and O. Degen and Stellbrink, {H. J.} and S. Staszewski and J. Bogner and G. F{\"a}tkenheuer and J. Kosmidis and P. Gargalianos and G. Xylomenos and J. Perdios and G. Panos and A. Filandras and E. Karabatsaki and H. Sambatakou and D. Banhegyi and F. Mulcahy and I. Yust and D. Turner and M. Burke and S. Pollack and G. Hassoun and S. Maayan and A. Chiesi and R. Esposito and I. Mazeu and C. Mussini and C. Arici and R. Pristera and F. Mazzotta and A. Gabbuti and V. Vullo and M. Lichtner and A. Chirianni and E. Montesarchio and M. Gargiulo and G. Antonucci and F. Iacomi and P. Narciso and C. Vlassi and M. Zaccarelli and A. Lazzarin and R. Finazzi and M. Galli and A. Ridolfo and {d'Arminio Monforte}, A. and B. Rozentale and P. Aldins and S. Chaplinskas and R. Hemmer and T. Staub and J. Bruun and A. Maeland and V. Ormaasen and B. Knysz and J. Gasiorowski and A. Horban and E. Bakowska and D. Prokopowicz and R. Flisiak and A. Boron-Kaczmarska and M. Pynka and E. Mularska and H. Trocha and E. Jablonowska and E. Malolepsza and K. Wojcik and F. Antunes and E. Valadas and K. Mansinho and F. Maltez and D. Duiculescu and V. Babes and A. Rakhmanova and E. Vinogradova and D. Jevtovic and M. Mokr{\'a}s and D. Stanekov{\'a} and J. Tomazic and J. Gonz{\'a}lez-Lahoz and V. Soriano and L. Martin-Carbonero and P. Labarga and S. Moreno and B. Clotet and A. Jou and R. Paredes and C. Tural and J. Puig and I. Bravo and Mir{\'o}, {J. M.} and P. Domingo and M. Gutierrez and G. Mateo and Sambeat, {M. A.} and A. Karlsson and Persson, {P. O.} and L. Flamholc and R. Weber and P. Francioli and M. Cavassini and B. Hirschel and E. Boffi and H. Furrer and M. Battegay and L. Elzi and E. Kravchenko and N. Chentsova and G. Kutsyna and S. Servitskiy and S. Antoniak and M. Krasnov and S. Barton and Johnson, {A. M.} and D. Mercey and Johnson, {M. A.} and M. Murphy and J. Weber and G. Scullard and M. Fisher and C. Leen and B. Gazzard and {D'Arminio Montforte}, A. and N. Friis-M{\o}ller and A. Cozzi-Lepri and W. Bannister and M. Ellefson and A. Borch and D. Podlekareva and J. Kjaer and L. Peters and J. Reekie and J. Kowalska",

year = "2010",

month = jul,

day = "17",

doi = "10.1097/QAD.0b013e328339fe53",

language = "אנגלית",

volume = "24",

pages = "1667--1678",

journal = "AIDS",

issn = "0269-9370",

publisher = "Lippincott Williams and Wilkins",

number = "11",

}

Mocroft, A, Kirk, O, Reiss, P, De Wit, S, Sedlacek, D, Beniowski, M, Gatell, J, Phillips, AN, Ledergerber, B, Lundgren, JD, Losso, M, Elias, C, Vetter, N, Zangerle, R, Karpov, I, Vassilenko, A, Mitsura, VM, Suetnov, O, Clumeck, N, Poll, B, Colebunders, R, Vandekerckhove, L, Hadziosmanovic, V, Kostov, K, Begovac, J, Machala, L, Rozsypal, H, Nielsen, J, Kronborg, G, Benfield, T, Larsen, M, Gerstoft, J, Katzenstein, T, Hansen, AB, Skinhøj, P, Pedersen, C, Oestergaard, L, Zilmer, K, Smidt, J, Ristola, M, Katlama, C, Viard, JP, Girard, PM, Livrozet, JM, Vanhems, P, Pradier, C, Dabis, F, Neau, D, Rockstroh, J, Schmidt, R, van Lunzen, J, Degen, O, Stellbrink, HJ, Staszewski, S, Bogner, J, Fätkenheuer, G, Kosmidis, J, Gargalianos, P, Xylomenos, G, Perdios, J, Panos, G, Filandras, A, Karabatsaki, E, Sambatakou, H, Banhegyi, D, Mulcahy, F, Yust, I, Turner, D, Burke, M, Pollack, S, Hassoun, G, Maayan, S, Chiesi, A, Esposito, R, Mazeu, I, Mussini, C, Arici, C, Pristera, R, Mazzotta, F, Gabbuti, A, Vullo, V, Lichtner, M, Chirianni, A, Montesarchio, E, Gargiulo, M, Antonucci, G, Iacomi, F, Narciso, P, Vlassi, C, Zaccarelli, M, Lazzarin, A, Finazzi, R, Galli, M, Ridolfo, A, d'Arminio Monforte, A, Rozentale, B, Aldins, P, Chaplinskas, S, Hemmer, R, Staub, T, Bruun, J, Maeland, A, Ormaasen, V, Knysz, B, Gasiorowski, J, Horban, A, Bakowska, E, Prokopowicz, D, Flisiak, R, Boron-Kaczmarska, A, Pynka, M, Mularska, E, Trocha, H, Jablonowska, E, Malolepsza, E, Wojcik, K, Antunes, F, Valadas, E, Mansinho, K, Maltez, F, Duiculescu, D, Babes, V, Rakhmanova, A, Vinogradova, E, Jevtovic, D, Mokrás, M, Staneková, D, Tomazic, J, González-Lahoz, J, Soriano, V, Martin-Carbonero, L, Labarga, P, Moreno, S, Clotet, B, Jou, A, Paredes, R, Tural, C, Puig, J, Bravo, I, Miró, JM, Domingo, P, Gutierrez, M, Mateo, G, Sambeat, MA, Karlsson, A, Persson, PO, Flamholc, L, Weber, R, Francioli, P, Cavassini, M, Hirschel, B, Boffi, E, Furrer, H, Battegay, M, Elzi, L, Kravchenko, E, Chentsova, N, Kutsyna, G, Servitskiy, S, Antoniak, S, Krasnov, M, Barton, S, Johnson, AM, Mercey, D, Johnson, MA, Murphy, M, Weber, J, Scullard, G, Fisher, M, Leen, C, Gazzard, B, D'Arminio Montforte, A, Friis-Møller, N, Cozzi-Lepri, A, Bannister, W, Ellefson, M, Borch, A, Podlekareva, D, Kjaer, J, Peters, L, Reekie, J & Kowalska, J 2010, 'Estimated glomerular filtration rate, chronic kidney disease and antiretroviral drug use in HIV-positive patients', AIDS, vol. 24, no. 11, pp. 1667-1678. https://doi.org/10.1097/QAD.0b013e328339fe53

TY - JOUR

T1 - Estimated glomerular filtration rate, chronic kidney disease and antiretroviral drug use in HIV-positive patients

AU - Mocroft, Amanda

AU - Kirk, Ole

AU - Reiss, Peter

AU - De Wit, Stephane

AU - Sedlacek, Dalibor

AU - Beniowski, Marek

AU - Gatell, Jose

AU - Phillips, Andrew N.

AU - Ledergerber, Bruno

AU - Lundgren, Jens D.

AU - Losso, M.

AU - Elias, C.

AU - Vetter, N.

AU - Zangerle, R.

AU - Karpov, I.

AU - Vassilenko, A.

AU - Mitsura, V. M.

AU - Suetnov, O.

AU - Clumeck, N.

AU - Poll, B.

AU - Colebunders, R.

AU - Vandekerckhove, L.

AU - Hadziosmanovic, V.

AU - Kostov, K.

AU - Begovac, J.

AU - Machala, L.

AU - Rozsypal, H.

AU - Nielsen, J.

AU - Kronborg, G.

AU - Benfield, T.

AU - Larsen, M.

AU - Gerstoft, J.

AU - Katzenstein, T.

AU - Hansen, A. B.

AU - Skinhøj, P.

AU - Pedersen, C.

AU - Oestergaard, L.

AU - Zilmer, K.

AU - Smidt, J.

AU - Ristola, M.

AU - Katlama, C.

AU - Viard, J. P.

AU - Girard, P. M.

AU - Livrozet, J. M.

AU - Vanhems, P.

AU - Pradier, C.

AU - Dabis, F.

AU - Neau, D.

AU - Rockstroh, J.

AU - Schmidt, R.

AU - van Lunzen, J.

AU - Degen, O.

AU - Stellbrink, H. J.

AU - Staszewski, S.

AU - Bogner, J.

AU - Fätkenheuer, G.

AU - Kosmidis, J.

AU - Gargalianos, P.

AU - Xylomenos, G.

AU - Perdios, J.

AU - Panos, G.

AU - Filandras, A.

AU - Karabatsaki, E.

AU - Sambatakou, H.

AU - Banhegyi, D.

AU - Mulcahy, F.

AU - Yust, I.

AU - Turner, D.

AU - Burke, M.

AU - Pollack, S.

AU - Hassoun, G.

AU - Maayan, S.

AU - Chiesi, A.

AU - Esposito, R.

AU - Mazeu, I.

AU - Mussini, C.

AU - Arici, C.

AU - Pristera, R.

AU - Mazzotta, F.

AU - Gabbuti, A.

AU - Vullo, V.

AU - Lichtner, M.

AU - Chirianni, A.

AU - Montesarchio, E.

AU - Gargiulo, M.

AU - Antonucci, G.

AU - Iacomi, F.

AU - Narciso, P.

AU - Vlassi, C.

AU - Zaccarelli, M.

AU - Lazzarin, A.

AU - Finazzi, R.

AU - Galli, M.

AU - Ridolfo, A.

AU - d'Arminio Monforte, A.

AU - Rozentale, B.

AU - Aldins, P.

AU - Chaplinskas, S.

AU - Hemmer, R.

AU - Staub, T.

AU - Bruun, J.

AU - Maeland, A.

AU - Ormaasen, V.

AU - Knysz, B.

AU - Gasiorowski, J.

AU - Horban, A.

AU - Bakowska, E.

AU - Prokopowicz, D.

AU - Flisiak, R.

AU - Boron-Kaczmarska, A.

AU - Pynka, M.

AU - Mularska, E.

AU - Trocha, H.

AU - Jablonowska, E.

AU - Malolepsza, E.

AU - Wojcik, K.

AU - Antunes, F.

AU - Valadas, E.

AU - Mansinho, K.

AU - Maltez, F.

AU - Duiculescu, D.

AU - Babes, V.

AU - Rakhmanova, A.

AU - Vinogradova, E.

AU - Jevtovic, D.

AU - Mokrás, M.

AU - Staneková, D.

AU - Tomazic, J.

AU - González-Lahoz, J.

AU - Soriano, V.

AU - Martin-Carbonero, L.

AU - Labarga, P.

AU - Moreno, S.

AU - Clotet, B.

AU - Jou, A.

AU - Paredes, R.

AU - Tural, C.

AU - Puig, J.

AU - Bravo, I.

AU - Miró, J. M.

AU - Domingo, P.

AU - Gutierrez, M.

AU - Mateo, G.

AU - Sambeat, M. A.

AU - Karlsson, A.

AU - Persson, P. O.

AU - Flamholc, L.

AU - Weber, R.

AU - Francioli, P.

AU - Cavassini, M.

AU - Hirschel, B.

AU - Boffi, E.

AU - Furrer, H.

AU - Battegay, M.

AU - Elzi, L.

AU - Kravchenko, E.

AU - Chentsova, N.

AU - Kutsyna, G.

AU - Servitskiy, S.

AU - Antoniak, S.

AU - Krasnov, M.

AU - Barton, S.

AU - Johnson, A. M.

AU - Mercey, D.

AU - Johnson, M. A.

AU - Murphy, M.

AU - Weber, J.

AU - Scullard, G.

AU - Fisher, M.

AU - Leen, C.

AU - Gazzard, B.

AU - D'Arminio Montforte, A.

AU - Friis-Møller, N.

AU - Cozzi-Lepri, A.

AU - Bannister, W.

AU - Ellefson, M.

AU - Borch, A.

AU - Podlekareva, D.

AU - Kjaer, J.

AU - Peters, L.

AU - Reekie, J.

AU - Kowalska, J.

PY - 2010/7/17

Y1 - 2010/7/17

N2 - 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 or below for persons with baseline eGFR of above 60 ml/min per 1.73 m or confirmed 25% decline in eGFR for persons with baseline eGFR of 60 ml/min per 1.73 m 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.

AB - 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 or below for persons with baseline eGFR of above 60 ml/min per 1.73 m or confirmed 25% decline in eGFR for persons with baseline eGFR of 60 ml/min per 1.73 m 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.

KW - antiretroviral drugs

KW - chronic kidney disease

KW - estimated glomerular filtration rate

UR - http://www.scopus.com/inward/record.url?scp=77954349373&partnerID=8YFLogxK

U2 - 10.1097/QAD.0b013e328339fe53

DO - 10.1097/QAD.0b013e328339fe53

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AN - SCOPUS:77954349373

SN - 0269-9370

VL - 24

SP - 1667

EP - 1678

JO - AIDS

JF - AIDS

IS - 11

ER -

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

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