Cheung Chi Yuen, Wong Kim Ming, Lee Man Po, Liu Yan Lun, Kwok Heidi, Chung Rita, Chau Ka Foon, Li Chung Ki, Li Chun Sang
Renal Unit, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong, China.
Nephrol Dial Transplant. 2007 Nov;22(11):3186-90. doi: 10.1093/ndt/gfm350. Epub 2007 Jun 16.
To evaluate the prevalence of chronic kidney disease (CKD) in Chinese HIV-infected population.
This was a cross-sectional point prevalence study. All Chinese HIV-infected patients who were followed up in a tertiary referral center in Hong Kong were recruited. Spot urine was saved for each patient to calculate urine protein-to-creatinine ratio (urine P/Cr). Those with urine P/Cr > 0.3 would have 24-h urine collection to determine the exact amount of proteinuria. Glomerular filtration rate (GFR) was estimated using MDRD formula. CKD was defined as GFR <60 ml/min/1.73 m2 and/or urine P/Cr > 0.3. Baseline demographic and clinical data were extracted from patients' records.
In total 322 patients were recruited. The mean age was 45.2 +/- 11.7 years. The duration of follow up was 6.0 +/- 4.0 years. There were 264 male and 58 female patients. The prevalence of hypertension, diabetes mellitus and CKD were 7.4%, 10.6% and 16.8%, respectively. Eighteen patients (5.6%) had GFR < 60 ml/min/1.73 m2 while 44 patients (13.7%) had spot urine P/Cr > 0.3. Among those with urine P/Cr > 0.3, 38 patients had 24-h urine collection. Using univariate analysis, CKD was found to be significantly (P < 0.05) associated with age, hypertension, diabetes, use of indinavir, lower CD4 count and peak viral load. Multivariate logistic regression revealed older age (P < 0.001), lower CD4 count (P = 0.02) and use of indinavir therapy (P = 0.04) were associated with development of CKD.
CKD is prevalent in Chinese HIV-infected patients. Patients with CKD were more likely to be older, associated with use of indinavir and CD4 nadir less than 100 cells/mul.
评估中国HIV感染人群中慢性肾脏病（CKD）的患病率。
这是一项横断面现患率研究。招募了在香港一家三级转诊中心接受随访的所有中国HIV感染患者。为每位患者留存随机尿样以计算尿蛋白肌酐比值（尿P/Cr）。尿P/Cr>0.3的患者将进行24小时尿蛋白定量检测以确定蛋白尿的确切量。采用MDRD公式估算肾小球滤过率（GFR）。CKD定义为GFR<60 ml/min/1.73 m2和/或尿P/Cr>0.3。从患者记录中提取基线人口统计学和临床数据。
共招募322例患者。平均年龄为45.2±11.7岁。随访时间为6.0±4.0年。男性264例，女性58例。高血压、糖尿病和CKD的患病率分别为7.4%、10.6%和16.8%。18例患者（5.6%）GFR<60 ml/min/1.73 m2，44例患者（13.7%）随机尿P/Cr>0.3。在尿P/Cr>0.3的患者中，38例进行了24小时尿蛋白定量检测。单因素分析发现，CKD与年龄、高血压、糖尿病、茚地那韦的使用、较低的CD4细胞计数和病毒载量峰值显著相关（P<0.05）。多因素logistic回归显示，年龄较大（P<0.001）、CD4细胞计数较低（P = 0.02）和使用茚地那韦治疗（P = 0.04）与CKD的发生相关。
CKD在中国HIV感染患者中普遍存在。CKD患者更可能年龄较大，与使用茚地那韦有关，且CD4细胞最低点低于100个/μl。
