Familial clustering of end-stage renal disease in blacks with HIV-associated nephropathy
Familial clustering of end-stage renal disease in blacks with HIV-associated nephropathy
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DOI：
10.1016/s0272-6386(99)70352-5
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发表时间：
1999-08-01
影响因子：
13.2
通讯作者：
Pegram, S
中科院分区：
文献类型：
--
作者：
Freedman, BI;Soucie, JM;Pegram, S
人类免疫缺陷病毒相关性肾病（HIVAN）在HIV感染的黑人中比白人更常见。黑人也表现出明显的终末期肾病（ESRD）的其他原因的家族聚集性，特别是糖尿病，高血压和系统性红斑狼疮相关的ESRD。我们比较了201例由HIVAN引起的ESRD黑人（病例）和50例无肾病的HIV感染黑人（对照）的ESRD家族史，以确定HIV相关的ESRD是否表现出熟悉的聚集性。使用东南肾脏理事会/ESRD网络6 ESRD家族史数据库确定病例。1993年9月至1998年10月开始透析的病例。连续确定对照组，1998年9月期间在传染病诊所接受治疗的血清肌酐浓度为1.3 mg/dL或更低且无蛋白尿的HIV感染黑人。病例组和对照组的平均年龄和家庭规模相似，24.4%的病例报告了ESRD的一级或二级亲属，而对照组为6%（P = 0.004）。Logistic回归分析，控制性别，家庭规模和年龄，显示病例比对照组有近亲属患ESRD的可能性高5.4倍（P = 0.007）。报告阳性家族史的49例HIVAN病例中，每例病例平均有1.2名额外的ESRD亲属（总计60名ESRD亲属），在网络6机构接受透析的27名亲属中，HIVAN未被列为ESRD的原因。我们的结论是，终末期肾病聚集在近25%的黑人家庭开始肾脏替代治疗的艾滋病毒，这种熟悉的聚集性终末期肾病似乎是独立的艾滋病毒感染。虽然不能排除环境因素，但在许多HIV感染的黑人中，肾衰竭的遗传易感性可能存在于随后发展为肾病的人群中。(C)1999年由国家肾脏基金会，公司。
Human immunodeficiency virus-associated nephropathy (HIVAN) develops more often in HIV-infected blacks than whites. Blacks also show marked familial clustering of other causes of end-stage renal disease (ESRD), particularly diabetes mellitus-, hypertension-, and systemic lupus erythematosus-associated ESRD, We compared the family history of ESRD in 201 blacks with ESRD caused by HIVAN (cases) to that of 50 HIV-infected blacks without renal disease (controls) to determine whether HIV-associated ESRD shows familiar aggregation. Cases were identified using the Southeastern Kidney Council/ESRD Network 6 Family History of ESRD database. Cases Initiated dialysis between September 1993 and October 1998. Controls were consecutively identified, HIV-infected blacks with serum creatinine concentrations of 1.3 mg/dL or less and no proteinuria, treated in an infectious disease clinic during September 1998, Cases and controls had similar mean ages and family sizes, First- or second-degree relatives with ESRD were reported by 24.4% of the cases compared with 6% of the controls (P = 0.004). Logistic regression analysis, controlling for sex, family size, and age, showed cases were 5.4 times more likely than controls to have close relatives with ESRD (P = 0.007). The 49 HIVAN cases who reported a positive family history had a mean of 1.2 additional relatives with ESRD per case (60 total relatives with ESRD), HIVAN was not listed as the cause of ESRD in any of the 27 relatives who underwent dialysis in Network 6 facilities. We conclude that ESRD clusters in the families of nearly 25% of blacks initiating renal replacement therapy for HIVAN, This familiar aggregation of ESRD appears to be independent of HIV infection. Although environmental factors cannot be excluded, it is possible an inherited susceptibility to renal failure is present in many blacks with HIV infection who subsequently develop nephropathy. (C) 1999 by the National Kidney Foundation, Inc.