High prevalence of renal dysfunction and association with risk of death amongst HIV-infected Ghanaians
Identifieur interne : 000677 ( Main/Exploration ); précédent : 000676; suivant : 000678High prevalence of renal dysfunction and association with risk of death amongst HIV-infected Ghanaians
Auteurs : Fred S. Sarfo [Ghana] ; Rosie Keegan [Royaume-Uni] ; Lambert Appiah [Ghana] ; Shaid Shakoor [Royaume-Uni] ; Richard Phillips [Ghana] ; Betty Norman [Ghana] ; Yasmin Hardy [Ghana] ; George Bedu-Addo [Ghana] ; Lydia Longstaff [Royaume-Uni] ; David R. Chadwick [Royaume-Uni]Source :
- The Journal of infection [ 0163-4453 ] ; 2013.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Mortalité.
English descriptors
- KwdEn :
Abstract
Objectives: To determine the prevalence of HIV-associated renal dysfunction (RD), identify risk factors for RD and explore the association between baseline renal function and mortality in an HIV-infected population in Ghana. Methods: Creatinine clearance (CrCl) or estimated glomerular filtration rate (eGFR) was calculated in patients attending an HIV clinic between 2004 and 2011 using Cockcroft-Gault, MDRD and CKD-EPI formulae. Logistic regression analysis was used to identify risk factors associated with RD and Kaplan-Meier/Cox proportional regression analyses to explore associations between baseline CrCl/eGFR and subsequent mortality. Results: In 3137 patients starting antiretroviral therapy (ART) the frequency (95%-CI) of RD, defined by CrCl <60 ml/min/1.73 m2 using Cockroft-Gault formula was 38.8% (37.1-40.5%). RD prevalence in a sub-population of 238 patients, including proteinuria in the definition, was 15.3% (10.3-22.1%) in ART-treated and 43.6% (34.0-53.7%) in ART-naïve patients. RD at baseline was associated with increasing age, low CD4 counts, advanced WHO stage and female gender. Cox proportional hazard analysis identified an increased hazard of death with decreasing CrCl, HR 1.46 (1.31-1.63) for each tertile lower than CrCl of 90 ml/min/1.73 m2. Conclusions: RD is very common in HIV-infected ART-naïve Ghanaians, and associated with increased risk of mortality. Screening and monitoring of RD is important in this setting, particularly as tenofovir use increases.
Affiliations:
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Sarfo</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Komfo Anokye Teaching Hospital</s1><s2>Kumasi</s2><s3>GHA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Ghana</country><wicri:noRegion>Komfo Anokye Teaching Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Keegan, Rosie" sort="Keegan, Rosie" uniqKey="Keegan R" first="Rosie" last="Keegan">Rosie Keegan</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>James Cook University Hospital</s1><s2>Middlesbrough</s2><s3>GBR</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>James Cook University Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Appiah, Lambert" sort="Appiah, Lambert" uniqKey="Appiah L" first="Lambert" last="Appiah">Lambert Appiah</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Komfo Anokye Teaching Hospital</s1><s2>Kumasi</s2><s3>GHA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Ghana</country><wicri:noRegion>Komfo Anokye Teaching Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Shakoor, Shaid" sort="Shakoor, Shaid" uniqKey="Shakoor S" first="Shaid" last="Shakoor">Shaid Shakoor</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>James Cook University Hospital</s1><s2>Middlesbrough</s2><s3>GBR</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>James Cook University Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Phillips, Richard" sort="Phillips, Richard" uniqKey="Phillips R" first="Richard" last="Phillips">Richard Phillips</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Komfo Anokye Teaching Hospital</s1><s2>Kumasi</s2><s3>GHA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Ghana</country><wicri:noRegion>Komfo Anokye Teaching Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Norman, Betty" sort="Norman, Betty" uniqKey="Norman B" first="Betty" last="Norman">Betty Norman</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Komfo Anokye Teaching Hospital</s1><s2>Kumasi</s2><s3>GHA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Ghana</country><wicri:noRegion>Komfo Anokye Teaching Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Hardy, Yasmin" sort="Hardy, Yasmin" uniqKey="Hardy Y" first="Yasmin" last="Hardy">Yasmin Hardy</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Komfo Anokye Teaching Hospital</s1><s2>Kumasi</s2><s3>GHA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Ghana</country><wicri:noRegion>Komfo Anokye Teaching Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Bedu Addo, George" sort="Bedu Addo, George" uniqKey="Bedu Addo G" first="George" last="Bedu-Addo">George Bedu-Addo</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Komfo Anokye Teaching Hospital</s1><s2>Kumasi</s2><s3>GHA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Ghana</country><wicri:noRegion>Komfo Anokye Teaching Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Longstaff, Lydia" sort="Longstaff, Lydia" uniqKey="Longstaff L" first="Lydia" last="Longstaff">Lydia Longstaff</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>James Cook University Hospital</s1><s2>Middlesbrough</s2><s3>GBR</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>James Cook University Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Chadwick, David R" sort="Chadwick, David R" uniqKey="Chadwick D" first="David R." last="Chadwick">David R. Chadwick</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>James Cook University Hospital</s1><s2>Middlesbrough</s2><s3>GBR</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>James Cook University Hospital</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">The Journal of infection</title><title level="j" type="abbreviated">J. infect.</title><idno type="ISSN">0163-4453</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">The Journal of infection</title><title level="j" type="abbreviated">J. infect.</title><idno type="ISSN">0163-4453</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AIDS</term><term>Dysfunction</term><term>Kidney</term><term>Mortality</term><term>Prevalence</term><term>Prognosis</term><term>Risk factor</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>SIDA</term><term>Prévalence</term><term>Rein</term><term>Trouble fonctionnel</term><term>Facteur risque</term><term>Mortalité</term><term>Pronostic</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Mortalité</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objectives: To determine the prevalence of HIV-associated renal dysfunction (RD), identify risk factors for RD and explore the association between baseline renal function and mortality in an HIV-infected population in Ghana. Methods: Creatinine clearance (CrCl) or estimated glomerular filtration rate (eGFR) was calculated in patients attending an HIV clinic between 2004 and 2011 using Cockcroft-Gault, MDRD and CKD-EPI formulae. Logistic regression analysis was used to identify risk factors associated with RD and Kaplan-Meier/Cox proportional regression analyses to explore associations between baseline CrCl/eGFR and subsequent mortality. Results: In 3137 patients starting antiretroviral therapy (ART) the frequency (95%-CI) of RD, defined by CrCl <60 ml/min/1.73 m<sup>2</sup> using Cockroft-Gault formula was 38.8% (37.1-40.5%). RD prevalence in a sub-population of 238 patients, including proteinuria in the definition, was 15.3% (10.3-22.1%) in ART-treated and 43.6% (34.0-53.7%) in ART-naïve patients. RD at baseline was associated with increasing age, low CD4 counts, advanced WHO stage and female gender. Cox proportional hazard analysis identified an increased hazard of death with decreasing CrCl, HR 1.46 (1.31-1.63) for each tertile lower than CrCl of 90 ml/min/1.73 m<sup>2</sup>. Conclusions: RD is very common in HIV-infected ART-naïve Ghanaians, and associated with increased risk of mortality. Screening and monitoring of RD is important in this setting, particularly as tenofovir use increases.</div></front></TEI><affiliations><list><country><li>Ghana</li><li>Royaume-Uni</li></country></list><tree><country name="Ghana"><noRegion><name sortKey="Sarfo, Fred S" sort="Sarfo, Fred S" uniqKey="Sarfo F" first="Fred S." last="Sarfo">Fred S. Sarfo</name></noRegion><name sortKey="Appiah, Lambert" sort="Appiah, Lambert" uniqKey="Appiah L" first="Lambert" last="Appiah">Lambert Appiah</name><name sortKey="Bedu Addo, George" sort="Bedu Addo, George" uniqKey="Bedu Addo G" first="George" last="Bedu-Addo">George Bedu-Addo</name><name sortKey="Hardy, Yasmin" sort="Hardy, Yasmin" uniqKey="Hardy Y" first="Yasmin" last="Hardy">Yasmin Hardy</name><name sortKey="Norman, Betty" sort="Norman, Betty" uniqKey="Norman B" first="Betty" last="Norman">Betty Norman</name><name sortKey="Phillips, Richard" sort="Phillips, Richard" uniqKey="Phillips R" first="Richard" last="Phillips">Richard Phillips</name></country><country name="Royaume-Uni"><noRegion><name sortKey="Keegan, Rosie" sort="Keegan, Rosie" uniqKey="Keegan R" first="Rosie" last="Keegan">Rosie Keegan</name></noRegion><name sortKey="Chadwick, David R" sort="Chadwick, David R" uniqKey="Chadwick D" first="David R." last="Chadwick">David R. Chadwick</name><name sortKey="Longstaff, Lydia" sort="Longstaff, Lydia" uniqKey="Longstaff L" first="Lydia" last="Longstaff">Lydia Longstaff</name><name sortKey="Shakoor, Shaid" sort="Shakoor, Shaid" uniqKey="Shakoor S" first="Shaid" last="Shakoor">Shaid Shakoor</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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