AustralieFrV1, Main, Exploration, bibRecord, 001823

Renal Impairment and Cardiovascular Disease in HIV-Positive Individuals: The D:A:D Study

Identifieur interne : 001823 ( Main/Exploration ); précédent : 001822; suivant : 001824

Renal Impairment and Cardiovascular Disease in HIV-Positive Individuals: The D:A:D Study

Auteurs : Lene Ryom [Danemark] ; Jens D. Lundgren [Danemark] ; Mike Ross ; Ole Kirk [Danemark] ; Matthew Law [Australie] ; Philippe Morlat ; Eric Fontas [France] ; Colette Smit [Pays-Bas] ; Christoph A. Fux [Suisse] ; Camilla I. Hatleberg [Danemark] ; Stéphane De Wit [Belgique] ; Caroline A. Sabin [Royaume-Uni] ; Amanda Mocroft [Royaume-Uni]

Source :

The Journal of Infectious Diseases [ 0022-1899 ] ; 2016.

RBID : PMC:5034954

Descripteurs français

KwdFr :
- Accident vasculaire cérébral (virologie), Accident vasculaire cérébral (étiologie), Adulte, Adulte d'âge moyen, Facteurs de risque, Femelle, Humains, Infarctus du myocarde (virologie), Infarctus du myocarde (étiologie), Infections à VIH (), Insuffisance rénale (virologie), Insuffisance rénale (étiologie), Maladies cardiovasculaires (virologie), Maladies cardiovasculaires (étiologie), Mâle, Rein (virologie), Taux de filtration glomérulaire (physiologie), Études prospectives.
MESH :
- physiologie : Taux de filtration glomérulaire.
- virologie : Accident vasculaire cérébral, Infarctus du myocarde, Insuffisance rénale, Maladies cardiovasculaires, Rein.
- étiologie : Accident vasculaire cérébral, Infarctus du myocarde, Insuffisance rénale, Maladies cardiovasculaires.
- Adulte, Adulte d'âge moyen, Facteurs de risque, Femelle, Humains, Infections à VIH, Mâle, Études prospectives.

English descriptors

KwdEn :
- Adult, Cardiovascular Diseases (etiology), Cardiovascular Diseases (virology), Female, Glomerular Filtration Rate (physiology), HIV Infections (complications), Humans, Kidney (virology), Male, Middle Aged, Myocardial Infarction (etiology), Myocardial Infarction (virology), Prospective Studies, Renal Insufficiency (etiology), Renal Insufficiency (virology), Risk Factors, Stroke (etiology), Stroke (virology).
MESH :
- complications : HIV Infections.
- etiology : Cardiovascular Diseases, Myocardial Infarction, Renal Insufficiency, Stroke.
- physiology : Glomerular Filtration Rate.
- virology : Cardiovascular Diseases, Kidney, Myocardial Infarction, Renal Insufficiency, Stroke.
- Adult, Female, Humans, Male, Middle Aged, Prospective Studies, Risk Factors.

Abstract

Background. While the association between renal impairment and cardiovascular disease (CVD) is well established in the general population, the association remains poorly understood in human immunodeficiency virus (HIV)–positive individuals.

Methods. Individuals with ≥2 estimated glomerular filtration rate (eGFR) measurements after 1 February 2004 were followed until CVD, death, last visit plus 6 months, or 1 February 2015. CVD was defined as the occurrence of centrally validated myocardial infarction, stroke, invasive cardiovascular procedures, or sudden cardiac death.

Results. During a median follow-up duration of 8.0 years (interquartile range, 5.4–8.9 years) 1357 of 35 357 individuals developed CVD (incidence rate, 5.2 cases/1000 person-years [95% confidence interval {CI}, 5.0–5.5]). Confirmed baseline eGFR and CVD were closely related with 1.8% of individuals (95% CI, 1.6%–2.0%) with an eGFR > 90 mL/minute/1.73 m² estimated to develop CVD at 5 years, increasing to 21.1% (95% CI, 6.6%–35.6%) among those with an eGFR ≤ 30 mL/minute/1.73 m². The strong univariate relationship between low current eGFR and CVD was primarily explained by increasing age in adjusted analyses, although all eGFRs ≤ 80 mL/minute/1.73 m² remained associated with 30%–40% increased CVD rates, and particularly high CVD rates among individuals with an eGFR ≤ 30 mL/minute/1.73 m² (incidence rate ratio, 3.08 [95% CI, 2.04–4.65]).

Conclusions. Among HIV-positive individuals in a large contemporary cohort, a strong relation between confirmed impaired eGFR and CVD was observed. This finding highlights the need for renal preventive measures and intensified monitoring for emerging CVD, particularly in older individuals with continuously low eGFRs.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5034954

DOI: 10.1093/infdis/jiw342
PubMed: 27485357
PubMed Central: 5034954

Affiliations:

Australie, Belgique, Danemark, France, Pays-Bas, Royaume-Uni, Suisse

Le document en format XML

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<country xml:lang="fr">Suisse</country>
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<term>Cardiovascular Diseases (virology)</term>
<term>Female</term>
<term>Glomerular Filtration Rate (physiology)</term>
<term>HIV Infections (complications)</term>
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<term>Risk Factors</term>
<term>Stroke (etiology)</term>
<term>Stroke (virology)</term>
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<term>Accident vasculaire cérébral (étiologie)</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Facteurs de risque</term>
<term>Femelle</term>
<term>Humains</term>
<term>Infarctus du myocarde (virologie)</term>
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<term>Infections à VIH ()</term>
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<term>Myocardial Infarction</term>
<term>Renal Insufficiency</term>
<term>Stroke</term>
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<front><div type="abstract" xml:lang="en"><p><bold><italic>Background.</italic>
</bold>
 While the association between renal impairment and cardiovascular disease (CVD) is well established in the general population, the association remains poorly understood in human immunodeficiency virus (HIV)–positive individuals.</p>
<p><bold><italic>Methods.</italic>
</bold>
 Individuals with ≥2 estimated glomerular filtration rate (eGFR) measurements after 1 February 2004 were followed until CVD, death, last visit plus 6 months, or 1 February 2015. CVD was defined as the occurrence of centrally validated myocardial infarction, stroke, invasive cardiovascular procedures, or sudden cardiac death.</p>
<p><bold><italic>Results.</italic>
</bold>
 During a median follow-up duration of 8.0 years (interquartile range, 5.4–8.9 years) 1357 of 35 357 individuals developed CVD (incidence rate, 5.2 cases/1000 person-years [95% confidence interval {CI}, 5.0–5.5]). Confirmed baseline eGFR and CVD were closely related with 1.8% of individuals (95% CI, 1.6%–2.0%) with an eGFR > 90 mL/minute/1.73 m<sup>2</sup>
 estimated to develop CVD at 5 years, increasing to 21.1% (95% CI, 6.6%–35.6%) among those with an eGFR ≤ 30 mL/minute/1.73 m<sup>2</sup>
. The strong univariate relationship between low current eGFR and CVD was primarily explained by increasing age in adjusted analyses, although all eGFRs ≤ 80 mL/minute/1.73 m<sup>2</sup>
 remained associated with 30%–40% increased CVD rates, and particularly high CVD rates among individuals with an eGFR ≤ 30 mL/minute/1.73 m<sup>2</sup>
 (incidence rate ratio, 3.08 [95% CI, 2.04–4.65]).</p>
<p><bold><italic>Conclusions.</italic>
</bold>
 Among HIV-positive individuals in a large contemporary cohort, a strong relation between confirmed impaired eGFR and CVD was observed. This finding highlights the need for renal preventive measures and intensified monitoring for emerging CVD, particularly in older individuals with continuously low eGFRs.</p>
</div>
</front>
</TEI>
<affiliations><list><country><li>Australie</li>
<li>Belgique</li>
<li>Danemark</li>
<li>France</li>
<li>Pays-Bas</li>
<li>Royaume-Uni</li>
<li>Suisse</li>
</country>
</list>
<tree><noCountry><name sortKey="Morlat, Philippe" sort="Morlat, Philippe" uniqKey="Morlat P" first="Philippe" last="Morlat">Philippe Morlat</name>
<name sortKey="Ross, Mike" sort="Ross, Mike" uniqKey="Ross M" first="Mike" last="Ross">Mike Ross</name>
</noCountry>
<country name="Danemark"><noRegion><name sortKey="Ryom, Lene" sort="Ryom, Lene" uniqKey="Ryom L" first="Lene" last="Ryom">Lene Ryom</name>
</noRegion>
<name sortKey="Hatleberg, Camilla I" sort="Hatleberg, Camilla I" uniqKey="Hatleberg C" first="Camilla I." last="Hatleberg">Camilla I. Hatleberg</name>
<name sortKey="Kirk, Ole" sort="Kirk, Ole" uniqKey="Kirk O" first="Ole" last="Kirk">Ole Kirk</name>
<name sortKey="Lundgren, Jens D" sort="Lundgren, Jens D" uniqKey="Lundgren J" first="Jens D." last="Lundgren">Jens D. Lundgren</name>
</country>
<country name="Australie"><noRegion><name sortKey="Law, Matthew" sort="Law, Matthew" uniqKey="Law M" first="Matthew" last="Law">Matthew Law</name>
</noRegion>
</country>
<country name="France"><noRegion><name sortKey="Fontas, Eric" sort="Fontas, Eric" uniqKey="Fontas E" first="Eric" last="Fontas">Eric Fontas</name>
</noRegion>
</country>
<country name="Pays-Bas"><noRegion><name sortKey="Smit, Colette" sort="Smit, Colette" uniqKey="Smit C" first="Colette" last="Smit">Colette Smit</name>
</noRegion>
</country>
<country name="Suisse"><noRegion><name sortKey="Fux, Christoph A" sort="Fux, Christoph A" uniqKey="Fux C" first="Christoph A." last="Fux">Christoph A. Fux</name>
</noRegion>
</country>
<country name="Belgique"><noRegion><name sortKey="De Wit, Stephane" sort="De Wit, Stephane" uniqKey="De Wit S" first="Stéphane" last="De Wit">Stéphane De Wit</name>
</noRegion>
</country>
<country name="Royaume-Uni"><noRegion><name sortKey="Sabin, Caroline A" sort="Sabin, Caroline A" uniqKey="Sabin C" first="Caroline A." last="Sabin">Caroline A. Sabin</name>
</noRegion>
<name sortKey="Mocroft, Amanda" sort="Mocroft, Amanda" uniqKey="Mocroft A" first="Amanda" last="Mocroft">Amanda Mocroft</name>
</country>
</tree>
</affiliations>
</record>

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Renal Impairment and Cardiovascular Disease in HIV-Positive Individuals: The D:A:D Study

Renal Impairment and Cardiovascular Disease in HIV-Positive Individuals: The D:A:D Study

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