TY - JOUR
T1 - Diminished impact of ethnicity as a risk factor for chronic kidney disease in the current HIV treatment era
AU - Schoffelen, Annelot F
AU - Smit, Colette
AU - van Lelyveld, Steven F L
AU - Vogt, Liffert
AU - Bauer, Martijn P
AU - Reiss, Peter
AU - Hoepelman, Andy I M
AU - Barth, Roos E
AU - ATHENA National Observational HIV Cohort
AU - Schölvinck, Elisabeth H.
N1 - © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: [email protected].
PY - 2015/7/15
Y1 - 2015/7/15
N2 - BACKGROUND: Chronic kidney disease (CKD) is an important comorbidity during human immunodeficiency virus (HIV) infection. Historically, HIV-associated nephropathy has been the predominant cause of CKD and has primarily been observed in people of African ancestry. This study aims to investigate the role of ethnicity in relation to CKD risk in recent years.METHODS: Analyses were performed including 16 836 patients from the Dutch AIDS Therapy Evaluation in the Netherlands (ATHENA) cohort. Baseline was defined as the first available creatinine level measurement after 1 January 2007; CKD was defined as a glomerular filtration rate of <60 mL/min/1.73 m(2). The associations between ethnicity and both prevalent CKD at baseline and incident CKD during follow-up were analyzed.RESULTS: The prevalence of baseline CKD was 2.7% (460 of 16 836 patients). Birth in a sub-Saharan African country (hereafter, "SSA origin") was significantly associated with baseline CKD (adjusted odds ratio 1.49; 95% confidence interval [CI], 1.04-2.13). During follow-up (median duration, 4.7 years; interquartile range, 2.4-5.2), the rate of incident CKD was 6.0 events per 1000 person-years. The risk of newly developing CKD was similar between patients of SSA origin and those born in Western Europe, Australia, or New Zealand (adjusted hazard ratio, 1.00; 95% CI, .63-1.59).CONCLUSIONS: Among HIV-infected patients in the Netherlands, being of SSA origin was associated with a higher baseline CKD prevalence but had no impact on newly developing CKD over time. This suggests a shift in the etiology of CKD from HIV-associated nephropathy toward other etiologies.
AB - BACKGROUND: Chronic kidney disease (CKD) is an important comorbidity during human immunodeficiency virus (HIV) infection. Historically, HIV-associated nephropathy has been the predominant cause of CKD and has primarily been observed in people of African ancestry. This study aims to investigate the role of ethnicity in relation to CKD risk in recent years.METHODS: Analyses were performed including 16 836 patients from the Dutch AIDS Therapy Evaluation in the Netherlands (ATHENA) cohort. Baseline was defined as the first available creatinine level measurement after 1 January 2007; CKD was defined as a glomerular filtration rate of <60 mL/min/1.73 m(2). The associations between ethnicity and both prevalent CKD at baseline and incident CKD during follow-up were analyzed.RESULTS: The prevalence of baseline CKD was 2.7% (460 of 16 836 patients). Birth in a sub-Saharan African country (hereafter, "SSA origin") was significantly associated with baseline CKD (adjusted odds ratio 1.49; 95% confidence interval [CI], 1.04-2.13). During follow-up (median duration, 4.7 years; interquartile range, 2.4-5.2), the rate of incident CKD was 6.0 events per 1000 person-years. The risk of newly developing CKD was similar between patients of SSA origin and those born in Western Europe, Australia, or New Zealand (adjusted hazard ratio, 1.00; 95% CI, .63-1.59).CONCLUSIONS: Among HIV-infected patients in the Netherlands, being of SSA origin was associated with a higher baseline CKD prevalence but had no impact on newly developing CKD over time. This suggests a shift in the etiology of CKD from HIV-associated nephropathy toward other etiologies.
KW - Adenine
KW - Adult
KW - Africa South of the Sahara
KW - Anti-HIV Agents
KW - Cross-Sectional Studies
KW - Female
KW - HIV Infections
KW - Humans
KW - Male
KW - Middle Aged
KW - Netherlands
KW - Organophosphonates
KW - Prevalence
KW - Renal Insufficiency, Chronic
KW - Risk Factors
U2 - 10.1093/infdis/jiv026
DO - 10.1093/infdis/jiv026
M3 - Article
C2 - 25601941
SN - 1537-6613
VL - 212
SP - 264
EP - 274
JO - The Journal of Infectious Diseases
JF - The Journal of Infectious Diseases
IS - 2
ER -