Acute renal failure in hospitalized patients with HIV: risk factors and impact on in-hospital mortality
Acute renal failure in hospitalized patients with HIV: risk factors and impact on in-hospital mortality
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DOI：
10.1097/01.aids.0000210610.52836.07
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发表时间：
2006-02-28
期刊：
影响因子：
3.8
通讯作者：
Klotman, ME
中科院分区：
文献类型：
--
作者：
Wyatt, CM;Arons, RR;Klotman, ME
背景资料：肾脏疾病是一个越来越重要的并发症的HIV.Objectives：研究急性肾功能衰竭的发病率和预测因素之前和之后的介绍HAART，急性肾功能衰竭的影响在医院死亡率在后HAART时代。1995年期间在纽约州急性护理医院住院的成人（前HAART）或2003年（后HAART）从国家规划和研究合作系统数据库中识别。HIV状态由主要或次要诊断代码定义。结果：1995年和2003年分别有52580例和25114例HIV感染者出院，其中1995年有52580例HIV感染者出院，2003年有25114例HIV感染者出院。与未感染患者相比，艾滋病毒感染患者在HAART前[调整后的比值比（OR），4.62; 95%置信区间（CI），4.30-4.95]和HAART后时期（调整后的OR，2.82; 95% CI，2.66-2.99）的急性肾衰竭发生率增加。在HAART后队列中，急性肾功能衰竭与传统的预测因素如年龄、糖尿病、慢性肾脏疾病以及急性或慢性肝功能衰竭或肝炎合并感染相关（所有比较P < 0.001）。急性肾功能衰竭与HAART后HIV感染患者的死亡率相关（OR，5.83; 95%CI，5.11-6.65）。结论：急性肾功能衰竭在HIV住院患者中仍然很常见，并与慢性肾脏疾病、肝脏疾病和死亡率增加相关。(C)2006年利平科特威廉姆斯&威尔金斯。
Background: Kidney disease is an increasingly important complication of HIV.Objectives: To examine the incidence and predictors of acute renal failure before and after the introduction of HAART, and the impact of acute renal failure on in-hospital mortality in the post-HAART era.Methods: Adults hospitalized in acute care hospitals in New York State during 1995 (pre-HAART) or 2003 (post-HAART) were identified from the state Planning and Research Cooperative System database. HIV status was defined by primary or secondary diagnosis code. The impact of HIV and HAART on the incidence of acute renal failure and mortality, and the impact of acute renal failure on mortality, was assessed using chi(2) analysis and multivariate regression.Results: There were 52 580 HIV-infected patients discharged from hospital in 1995 and 25 114 in 2003. Compared with uninfected patients, HIV-infected patients had an increased incidence of acute renal failure in both the pre-HAART [adjusted odds ratio (OR), 4.62; 95% confidence interval (CI), 4.30-4.95] and post-HAART eras (adjusted OR, 2.82; 95% CI, 2.66-2.99). In the post-HAART cohort, acute renal failure was associated with traditional predictors such as age, diabetes mellitus, and chronic kidney disease, as well as acute or chronic liver failure or hepatitis coinfection (P < 0.001 for all comparisons). Acute renal failure was associated with mortality among HIV-infected patients in the post-HAART era (OR, 5.83; 95% CI, 5.11-6.65).Conclusions: Acute renal failure remains common among hospitalized patients with HIV and is associated with chronic kidney disease, liver disease, and increased mortality. (C) 2006 Lippincott Williams & Wilkins.