The epidemiology of kidney disease in people of African ancestry with HIV in the UK.
The epidemiology of kidney disease in people of African ancestry with HIV in the UK.
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DOI：
10.1016/j.eclinm.2021.101006
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发表时间：
2021-08
影响因子：
15.1
通讯作者：
GEN-AFRICA study group
中科院分区：
文献类型：
--
作者：
Hung RKY;Santana-Suarez B;Binns-Roemer E;Campbell L;Bramham K;Hamzah L;Fox J;Burns JE;Clarke A;Vincent R;Jones R;Price DA;Onyango D;Harber M;Hilton R;Booth JW;Sabin CA;Winkler CA;Post FA;GEN-AFRICA study group
慢性肾脏疾病（CKD）是全球发病率和死亡率的主要原因。在非洲血统和人类免疫缺陷病毒（HIV）感染的人群中，CKD的风险增加。我们进行了一项横断面研究，调查了2018年5月至2020年2月期间英国撒哈拉以南非洲艾滋病毒携带者的祖先地区（东非、中非、南非或西非）与肾脏疾病之间的关系。主要结局是肾功能损害（估计肾小球滤过率[eGFR] <60 mL/min/1.73 m2）。次要结局是5期CKD （eGFR <15 ml/min/1.73 m2，透析超过3个月或接受过肾移植）、蛋白尿（尿蛋白/肌酐比值>50 mg/mmol）和活检证实的hiv相关肾病（HIVAN）、局灶节段性肾小球硬化（FSGS）或动脉肾硬化。多变量稳健泊松回归估计了非洲血统地区对肾脏疾病结局的影响。在2468名参与者中（平均年龄48.1 [SD 9.8]岁，62%为女性），193名患有肾脏损害，87名患有5期CKD， 126名患有蛋白尿，43名患有hiv /FSGS或动脉肾硬化。在调整了人口统计学特征、艾滋病毒和几个CKD危险因素并以东非血统为参照后，西非血统与肾脏损害（患病率比[PR] 2.06 [95% CI 1.40-3.04]）和5期CKD（患病率比[PR] 2.23[1.23-4.04]）相关，但与蛋白尿无关（患病率比[PR] 1.27[0.78-2.05]）。西非血统（与东非/南非血统相比）也与hiv /FSGS或肾活检动脉肾硬化的诊断密切相关（PR为6.44[2.42-17.14]）。我们的研究结果表明，西非血统的艾滋病毒携带者患肾脏疾病的风险增加。虽然我们不能排除残留混杂的可能性，但原产地理区域似乎是CKD的一个强大的独立危险因素，因为这种关联似乎不能被几种人口统计学、HIV或肾脏危险因素所解释。
Chronic kidney disease (CKD) is a leading cause of morbidity and mortality globally. The risk of CKD is increased in people of African ancestry and with Human Immunodeficiency Virus (HIV) infection. We conducted a cross-sectional study investigating the relationship between region of ancestry (East, Central, South or West Africa) and kidney disease in people of sub-Saharan African ancestry with HIV in the UK between May 2018 and February 2020. The primary outcome was renal impairment (estimated glomerular filtration rate [eGFR] of <60 mL/min/1.73 m2). Secondary outcomes were stage 5 CKD (eGFR <15 ml/min/1.73 m2, on dialysis for over 3 months or who had received a kidney transplant), proteinuria (urine protein/creatinine ratio >50 mg/mmol), and biopsy-confirmed HIV-associated nephropathy (HIVAN), focal segmental glomerulosclerosis (FSGS) or arterionephrosclerosis. Multivariable robust Poisson regression estimated the effect of region of African ancestry on kidney disease outcomes. Of the 2468 participants (mean age 48.1 [SD 9.8] years, 62% female), 193 had renal impairment, 87 stage 5 CKD, 126 proteinuria, and 43 HIVAN/FSGS or arterionephrosclerosis. After adjusting for demographic characteristics, HIV and several CKD risk factors and with East African ancestry as referent, West African ancestry was associated with renal impairment (prevalence ratio [PR] 2.06 [95% CI 1.40–3.04]) and stage 5 CKD (PR 2.23 [1.23–4.04]), but not with proteinuria (PR 1.27 [0.78–2.05]). West African ancestry (as compared to East/South African ancestry) was also strongly associated with a diagnosis of HIVAN/FSGS or arterionephrosclerosis on kidney biopsy (PR 6.44 [2.42–17.14]). Our results indicate that people of West African ancestry with HIV are at increased risk of kidney disease. Although we cannot rule out the possibility of residual confounding, geographical region of origin appears to be a strong independent risk factor for CKD as the association did not appear to be explained by several demographic, HIV or renal risk factors.
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DOI：
10.1016/s0140-6736(18)32203-7
发表时间：
2018-11-10
期刊：
Lancet (London, England)
影响因子：
--
作者：
GBD 2017 Causes of Death Collaborators
通讯作者：
GBD 2017 Causes of Death Collaborators
DOI：
10.1126/science.1193032
发表时间：
2010-08-13
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Genovese G;Friedman DJ;Ross MD;Lecordier L;Uzureau P;Freedman BI;Bowden DW;Langefeld CD;Oleksyk TK;Uscinski Knob AL;Bernhardy AJ;Hicks PJ;Nelson GW;Vanhollebeke B;Winkler CA;Kopp JB;Pays E;Pollak MR
通讯作者：
Pollak MR
影响因子：
3.7
作者：
Ekrikpo UE;Kengne AP;Bello AK;Effa EE;Noubiap JJ;Salako BL;Rayner BL;Remuzzi G;Okpechi IG
通讯作者：
Okpechi IG
影响因子：
3.8
作者：
Mocroft, Amanda;Kirk, Ole;Lundgren, Jens D.
通讯作者：
Lundgren, Jens D.
影响因子：
39.2
作者：
Stevens, Paul E.;Levin, Adeera
通讯作者：
Levin, Adeera