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Keywords:

  • HIV infection;
  • kidney;
  • renal impairment

Objectives

The aims of the present study were to estimate the prevalence of renal impairment (RI) among HIV-infected adult patients and to investigate the associated factors.

Methods

A cross-sectional survey was conducted in a French hospital-based cohort. Clearance of creatinine (CC) was calculated using the Cockcroft–Gault formula. Four stages of RI were defined: mild (60–90 mL/min), moderate (30–60), severe (15–30) and end stage (<15). Logistic regression models were used to investigate factors associated with RI.

Results

The male/female ratio of the 2588 patients enrolled was 3:1 and the median age was 42 years. At the time of assessment of CC, the median CD4 count was 430 cells/μL and HIV plasma viral load (VL) was<50 copies/mL in 60%. The overall prevalence of RI was 39.0%: 34.2% mild, 4.4% moderate, 0.3% severe and 0.2% end-stage. Mild RI was associated with female gender [odds ratio (OR)=3.3: 95% CI 2.6–4.3)], age >50 years (OR=9.8: 7.4–13.0) and 40–50 years (OR=1.9: 1.5–2.4), body mass index (BMI) <22 kg/m2 (OR=3.3: 2.7–4.3) and tenofovir exposure (OR=1.4: 1.0–1.9 for <1 year and OR=1.5: 1.2–2.0 for >1 year). Advanced RI (CC <60 mL/min) was associated with age >50 years (OR=5.6: 2.9–10.9) and 40–50 years (OR=2.2: 1.1–1.4), BMI <22 kg/m2 (OR=1.5: 1.0–2.4), hypertension (OR=2.5: 1.4–2.5) and indinavir (IDV) exposure >1 year (OR=2.3: 1.5–3.6).

Conclusion

This survey confirms the high prevalence of RI in HIV-infected patients and indicates the importance of the investigation of renal function especially in women, older patients, those with a low BMI or treated with tenofovir or IDV.