Diminished impact of ethnicity as a risk factor for chronic kidney disease in the current HIV treatment era

Annelot F Schoffelen*, Colette Smit, the AIDS Therapy Evaluation in the Netherlands (ATHENA) Observational HIV Cohort, Steven F L van Lelyveld, Liffert Vogt, Martijn P Bauer, Peter Reiss, Andy I M Hoepelman, Roos E Barth, Hannelore Bax

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

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.

Original languageEnglish
Pages (from-to)264-274
Number of pages11
JournalJournal of Infectious Diseases
Volume212
Issue number2
Early online date18 Jan 2015
DOIs
Publication statusPublished - 15 Jul 2015

Bibliographical note

© 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].

Research programs

  • EMC MM-04-28-04
  • EMC MM-04-54-08-A

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