BACKGROUND AND OBJECTIVES: Cocaine causes kidney damage, but data linking cocaine use to chronic kidney disease in HIV patients is not described. This study was conducted to evaluate the possible association of cocaine use and histopathologic findings on biopsy in this population. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Kidney biopsies that were performed in HIV-infected patients during the course of 11 yr were reviewed. Demographic and clinical data were collected. Hypertensive changes were defined on the basis of the Banff 97 classification. Criteria of both arterial intimal fibrosis and thickening and hyaline arteriolosclerosis were used and graded as absent (0), mild (1), moderate (2), and severe (3). Hypertensive renal changes were considered present when the combined pathology score was > or = 2. To minimize confounding, those with hypertension or diabetes were excluded. RESULTS: Of the 193 HIV patients who underwent kidney biopsy, 53 had no history of hypertension or diabetes with HIV infection. Of those, 29 (55%) had hypertensive renal changes on kidney biopsy. Cocaine use was present in 16 (55%) of 29 with hypertensive renal changes compared with six (25%) of 24 without hypertensive renal changes (odds ratio [OR] 3.7; 95% confidence interval [CI] 1.2 to 11.7). In the adjusted analyses, only age (/yr; OR 1.08; 95% CI 1.00 to 1.16) and cocaine use (OR 3.55; 95% CI 1.04 to 12.14) were significantly associated with hypertensive renal changes on renal biopsy. CONCLUSIONS: Cocaine use is associated with hypertensive renal changes in HIV-infected patients in the absence of hypertension and diabetes.
BACKGROUND AND OBJECTIVES:Cocaine causes kidney damage, but data linking cocaine use to chronic kidney disease in HIVpatients is not described. This study was conducted to evaluate the possible association of cocaine use and histopathologic findings on biopsy in this population. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Kidney biopsies that were performed in HIV-infectedpatients during the course of 11 yr were reviewed. Demographic and clinical data were collected. Hypertensive changes were defined on the basis of the Banff 97 classification. Criteria of both arterial intimal fibrosis and thickening and hyaline arteriolosclerosis were used and graded as absent (0), mild (1), moderate (2), and severe (3). Hypertensive renal changes were considered present when the combined pathology score was > or = 2. To minimize confounding, those with hypertension or diabetes were excluded. RESULTS: Of the 193 HIVpatients who underwent kidney biopsy, 53 had no history of hypertension or diabetes with HIV infection. Of those, 29 (55%) had hypertensive renal changes on kidney biopsy. Cocaine use was present in 16 (55%) of 29 with hypertensive renal changes compared with six (25%) of 24 without hypertensive renal changes (odds ratio [OR] 3.7; 95% confidence interval [CI] 1.2 to 11.7). In the adjusted analyses, only age (/yr; OR 1.08; 95% CI 1.00 to 1.16) and cocaine use (OR 3.55; 95% CI 1.04 to 12.14) were significantly associated with hypertensive renal changes on renal biopsy. CONCLUSIONS:Cocaine use is associated with hypertensive renal changes in HIV-infectedpatients in the absence of hypertension and diabetes.
Authors: Michelle M Estrella; Rulan S Parekh; Alison Abraham; Brad C Astor; Lynda A Szczech; Kathryn Anastos; Jack A Dehovitz; Daniel J Merenstein; C Leigh Pearce; Phyllis C Tien; Mardge H Cohen; Stephen J Gange Journal: J Acquir Immune Defic Syndr Date: 2010-10 Impact factor: 3.731
Authors: Gregory M Lucas; Yuezhou Jing; Mark Sulkowski; Alison G Abraham; Michelle M Estrella; Mohamed G Atta; Derek M Fine; Marina B Klein; Michael J Silverberg; M John Gill; Richard D Moore; Kelly A Gebo; Timothy R Sterling; Adeel A Butt Journal: J Infect Dis Date: 2013-07-31 Impact factor: 5.226
Authors: Elizabeth L Yanik; Gregory M Lucas; David Vlahov; Gregory D Kirk; Shruti H Mehta Journal: Clin J Am Soc Nephrol Date: 2010-08-12 Impact factor: 8.237
Authors: Shikha Garg; Melanie Hoenig; Erika M Edwards; Caleb Bliss; Timothy Heeren; Sheila Tumilty; Alexander Y Walley; Margaret J Koziel; Paul R Skolnik; C Robert Horsburgh; Deborah Cotton Journal: AIDS Patient Care STDS Date: 2011-02-10 Impact factor: 5.078
Authors: Gregory M Lucas; Mohamed G Atta; Derek M Fine; Allison M McFall; Michelle M Estrella; Katie Zook; James H Stein Journal: Arterioscler Thromb Vasc Biol Date: 2016-09-08 Impact factor: 8.311
Authors: Gregory M Lucas; Mohamed G Atta; Katie Zook; Allison M McFall; Shruti H Mehta; Derek M Fine; James H Stein; George J Schwartz Journal: AIDS Date: 2016-02-20 Impact factor: 4.177