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The incidence and dynamic risk factors of chronic kidney disease among people with HIV
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AIDS 2023
Existing literature suggested that PWH had a 1.8 to seven-fold increased risk of CKD compared with HIV-negative populations [9,10].
We investigate the incidence of chronic kidney disease (CKD) among people with HIV (PWH) and the dynamic risk factors associated with CKD incidence.
A population-based cohort study of PWH in South Carolina.
Results:
Among 9514 PWH, the incidence of CKD was 12.39 per 1000 person-years. The overall model indicated that conventional risk factors, such as hypertension, dyslipidemia, cardiovascular disease, and diabetes, were significantly associated with a higher risk of developing CKD. HIV-related characteristics, such as high percentage of days with viral suppression, recent CD4+ cell count, and percentage of retention in care, were associated with a lower risk of CKD compared with their counterparts. In the subgroup analysis, the results were similar for the 5-year and 6–10 years follow-up groups. Among patients who did not develop CKD by the 10th year, the risk factors for developing CKD within 11–15 years were dyslipidemia, diabetes, low recent CD4+ cell count, and short duration of retention in care while other predictors vanished.
Conclusion:
Diabetes, CD4+ cell count, and retention in care were persistently associated with CKD despite of follow-up duration. Closely monitoring diabetes and improving CD4+ cell count and retention in care are important to lower the risk of CKD in PWH.
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