Estimated glomerular filtration rate, chronic kidney disease and antiretroviral drug use in HIV-positive patients

• DOI: 10.1097/qad.0b013e328339fe53
• Publication Date: 2010-06-02T14:57:40Z
• Authors: Amanda Mocroft; Ole Kirk; Peter Reiss; Stephane De Wit; Dalibor Sedlacek; Marek Beniowski; Jose Gatell; Andrew N Phillips; Bruno Ledergerber; Jens D Lundgren
• Keywords: Antiretroviral drug

Chronic kidney disease (CKD) in HIV-positive persons might be caused by both HIV and traditional or non-HIV-related factors. Our objective was to investigate long-term exposure specific antiretroviral drugs CKD.A cohort study including 6843 with at least three serum creatinine measurements corresponding body weight from 2004 onwards.CKD defined as either confirmed (two >or=3 months apart) estimated glomerular filtration rate (eGFR) of 60 ml/min per 1.73 m below for baseline eGFR above 25% decline less, using the Cockcroft-Gault formula. Poisson regression used determine factors associated CKD.Two hundred twenty-five (3.3%) progressed CKD during 21 482 person-years follow-up, an incidence 1.05 100 follow-up [95% confidence interval (CI) 0.91-1.18]; median 3.7 years (interquartile range 2.8-5.7). After adjustment other confounding variables, increasing cumulative tenofovir [incidence ratio (IRR) year 1.16, 95% CI 1.06-1.25, P < 0.0001), indinavir (IRR 1.12, 1.06-1.18, atazanavir 1.21, 1.09-1.34, = 0.0003) lopinavir/r 1.08, 1.01-1.16, 0.030) were a significantly increased CKD. Consistent results observed wide-ranging sensitivity analyses, although marginal statistical significance lopinavir/r. No CKD.In this nonrandomized large cohort, higher CKD, true atazanavir, whereas less clear.