BACKGROUND: In 2005, the Infectious Disease Society of America published a guideline recommending that all patients with human immunodeficiency virus (HIV) be screened for kidney disease. We initiated a screening program for kidney disease in a dedicated HIV clinic that follows 1,631 patients. METHODS: The screening consisted of a serum creatinine, an estimated glomerular filtration rate (eGFR) as defined by the abbreviated Modification of Diet in Renal Disease equation, and a standard urinalysis for proteinuria. Subjects were identified as having a positive screen if they had 1+ proteinuria or greater on a standard urinalysis or an eGFR of less than 60 ml/min/ 1.73 m2. After 1 year of screening, a retrospective chart review was conducted to determine the efficacy of screening. Bivariate associations were assessed for each outcome. A multiple logistic regression analysis was conducted first with main effects models and then for all variables and interactions. RESULTS: 941 subjects that did not have previously documented chronic kidney disease were screened and 96 (10.2%) met the definition of CKD. 9% of subjects had proteinuria and 2.4% had a qualifying eGFR. In multivariate analysis diabetes, hypertension, and low CD4 count (< 200 cells per mm3), low viral load (< 400 copies/ml) displayed strong associations with proteinuria. In the case of reduced eGFR, diabetes and age retained strong associations while the association with hypertension had borderline significance. CONCLUSION: This study emphasizes the potential of similar screening programs to identify early or mild CKD in an ambulatory population of patients with HIV.
BACKGROUND: In 2005, the Infectious Disease Society of America published a guideline recommending that all patients with human immunodeficiency virus (HIV) be screened for kidney disease. We initiated a screening program for kidney disease in a dedicated HIV clinic that follows 1,631 patients. METHODS: The screening consisted of a serum creatinine, an estimated glomerular filtration rate (eGFR) as defined by the abbreviated Modification of Diet in Renal Disease equation, and a standard urinalysis for proteinuria. Subjects were identified as having a positive screen if they had 1+ proteinuria or greater on a standard urinalysis or an eGFR of less than 60 ml/min/ 1.73 m2. After 1 year of screening, a retrospective chart review was conducted to determine the efficacy of screening. Bivariate associations were assessed for each outcome. A multiple logistic regression analysis was conducted first with main effects models and then for all variables and interactions. RESULTS: 941 subjects that did not have previously documented chronic kidney disease were screened and 96 (10.2%) met the definition of CKD. 9% of subjects had proteinuria and 2.4% had a qualifying eGFR. In multivariate analysis diabetes, hypertension, and low CD4 count (< 200 cells per mm3), low viral load (< 400 copies/ml) displayed strong associations with proteinuria. In the case of reduced eGFR, diabetes and age retained strong associations while the association with hypertension had borderline significance. CONCLUSION: This study emphasizes the potential of similar screening programs to identify early or mild CKD in an ambulatory population of patients with HIV.
Authors: Udeme E Ekrikpo; Andre P Kengne; Aminu K Bello; Emmanuel E Effa; Jean Jacques Noubiap; Babatunde L Salako; Brian L Rayner; Giuseppe Remuzzi; Ikechi G Okpechi Journal: PLoS One Date: 2018-04-16 Impact factor: 3.240
Authors: Eun Jin Kim; Jin Young Ahn; Youn Jeong Kim; Seong Heon Wie; Dae Won Park; Joon Young Song; Hee Jung Choi; Hyun Ha Chang; Bo Youl Choi; Yunsu Choi; Ju Yeon Choi; Myung Guk Han; Chun Kang; June Myung Kim; Jun Yong Choi Journal: Infect Chemother Date: 2017-09