Prevalence and factors associated with renal impairment in HIV-infected patients, ANRS C03 Aquitaine Cohort, France

Authors

  • EK Déti,

    1. Institut National de la Santé et de la Recherche Médicale (INSERM) U897, Bordeaux, F-33076, France
    2. Centre Hospitalier Universitaire (CHU), Bordeaux F-33076, France
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  • R Thiébaut,

    1. Institut National de la Santé et de la Recherche Médicale (INSERM) U897, Bordeaux, F-33076, France
    2. Coordination Régionale de la lutte contre l'infection due au VIH (COREVIH), Bordeaux F-33076, France
    3. Université Victor Segalen Bordeaux 2, Bordeaux F-33076, France
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  • F Bonnet,

    1. Institut National de la Santé et de la Recherche Médicale (INSERM) U897, Bordeaux, F-33076, France
    2. Centre Hospitalier Universitaire (CHU), Bordeaux F-33076, France
    3. Coordination Régionale de la lutte contre l'infection due au VIH (COREVIH), Bordeaux F-33076, France
    4. Université Victor Segalen Bordeaux 2, Bordeaux F-33076, France
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  • S Lawson-Ayayi,

    1. Institut National de la Santé et de la Recherche Médicale (INSERM) U897, Bordeaux, F-33076, France
    2. Centre Hospitalier Universitaire (CHU), Bordeaux F-33076, France
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  • M Dupon,

    1. Centre Hospitalier Universitaire (CHU), Bordeaux F-33076, France
    2. Coordination Régionale de la lutte contre l'infection due au VIH (COREVIH), Bordeaux F-33076, France
    3. Université Victor Segalen Bordeaux 2, Bordeaux F-33076, France
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  • D Neau,

    1. Centre Hospitalier Universitaire (CHU), Bordeaux F-33076, France
    2. Coordination Régionale de la lutte contre l'infection due au VIH (COREVIH), Bordeaux F-33076, France
    3. Université Victor Segalen Bordeaux 2, Bordeaux F-33076, France
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  • JL Pellegrin,

    1. Centre Hospitalier Universitaire (CHU), Bordeaux F-33076, France
    2. Coordination Régionale de la lutte contre l'infection due au VIH (COREVIH), Bordeaux F-33076, France
    3. Université Victor Segalen Bordeaux 2, Bordeaux F-33076, France
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  • D Malvy,

    1. Centre Hospitalier Universitaire (CHU), Bordeaux F-33076, France
    2. Coordination Régionale de la lutte contre l'infection due au VIH (COREVIH), Bordeaux F-33076, France
    3. Université Victor Segalen Bordeaux 2, Bordeaux F-33076, France
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  • S Tchamgoué,

    1. Coordination Régionale de la lutte contre l'infection due au VIH (COREVIH), Bordeaux F-33076, France
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  • F Dabis,

    1. Institut National de la Santé et de la Recherche Médicale (INSERM) U897, Bordeaux, F-33076, France
    2. Centre Hospitalier Universitaire (CHU), Bordeaux F-33076, France
    3. Coordination Régionale de la lutte contre l'infection due au VIH (COREVIH), Bordeaux F-33076, France
    4. Université Victor Segalen Bordeaux 2, Bordeaux F-33076, France
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  • P Morlat,

    1. Institut National de la Santé et de la Recherche Médicale (INSERM) U897, Bordeaux, F-33076, France
    2. Centre Hospitalier Universitaire (CHU), Bordeaux F-33076, France
    3. Coordination Régionale de la lutte contre l'infection due au VIH (COREVIH), Bordeaux F-33076, France
    4. Université Victor Segalen Bordeaux 2, Bordeaux F-33076, France
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  • for the Groupe d'Epidémiologie Clinique du SIDA en Aquitaine (GECSA)

    1. Institut National de la Santé et de la Recherche Médicale (INSERM) U897, Bordeaux, F-33076, France
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  • Reported in part at: Fourth IAS Conference on HIV Pathogenesis, Treatment and Prevention, Sydney, 2007 (Abstract MOPEB066).
    4ème Conférence Francophone VIH/SIDA, Paris, 2007 (Résumé 185).

  • *See composition in Appendix.

Philippe Morlat, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint André, 1 Rue Jean Burguet, 33076 Bordeaux Cedex, France. Tel: +33 5 56 79 58 23 or 26; fax: +33 5 56 79 58 22; e-mail: philippe.morlat@chu-bordeaux.fr

Abstract

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.

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