Estimated glomerular filtration rate, chronic kidney disease and antiretroviral drug use in HIV-positive patients
Estimated glomerular filtration rate, chronic kidney disease and antiretroviral drug use in HIV-positive patients
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DOI：
10.1097/qad.0b013e328339fe53
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发表时间：
2010-07-01
期刊：
影响因子：
3.8
通讯作者：
Lundgren, Jens D.
中科院分区：
文献类型：
--
作者：
Mocroft, Amanda;Kirk, Ole;Lundgren, Jens D.
目的：HIV感染者的慢性肾脏病(CKD)可能是由HIV和传统或非HIV相关因素共同引起的。我们的目标是调查长期接触特定抗逆转录病毒药物和CKD的情况。设计：一项队列研究，包括6843名HIV阳性患者，自2004年以来，至少测量了三次血肌酐和相应的体重。=相隔3个月)使用Cockcroft-Gault公式，基线EGFR高于每1.73米(2)60毫升/分钟或更低的人的肾小球滤过率(EGFR)估计为每1.73米(2)60毫升/分钟或以下，或基线EGFR为每1.73米(2)或更低的人的EGFR下降25%。结果：在21482人年随访中，225人(3.3%)进展为CKD，每百人年随访率为1.05[95%可信区间(CI)0.91~1.18]，中位随访期为3.7年(四分位数范围2.8~5.7)。在调整了与慢性肾脏病相关的传统因素和其他混杂变量后，每年增加替诺福韦的累积暴露[发病率比(IRR)]1.16，95%可信区间1.06-1.25，P
Objectives: 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 to specific antiretroviral drugs and CKD.Design: A cohort study including 6843 HIV-positive persons with at least three serum creatinine measurements and corresponding body weight measurements from 2004 onwards.Methods: CKD was defined as either confirmed (two measurements >= 3 months apart) estimated glomerular filtration rate (eGFR) of 60 ml/min per 1.73 m(2) or below for persons with baseline eGFR of above 60 ml/min per 1.73 m(2) or confirmed 25% decline in eGFR for persons with baseline eGFR of 60 ml/min per 1.73 m(2) or less, using the Cockcroft-Gault formula. Poisson regression was used to determine factors associated with CKD.Results: Two hundred and twenty-five (3.3%) persons progressed to CKD during 21 482 person-years follow-up, an incidence of 1.05 per 100 person-years follow-up [95% confidence interval (CI) 0.91-1.18]; median follow-up was 3.7 years (interquartile range 2.8-5.7). After adjustment for traditional factors associated with CKD and other confounding variables, increasing cumulative exposure to tenofovir [incidence rate ratio (IRR) per year 1.16, 95% CI 1.06-1.25, P