Department of Infectious Disease, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Nephrology (Carlton). 2013 Apr;18(4):307-12. doi: 10.1111/nep.12031.
The aim of the study was to evaluate the prevalence and risk factors of chronic kidney disease (CKD) among HIV-infected antiretroviral therapy (ART)-naïve patients in Mainland China.
In this multicenter cross-sectional study, glomerular filtration rate (GFR) was calculated using the Modification of Diet in Renal Disease (MDRD) equation. CKD was defined as GFRMDRD < 60 mL/min per 1.73 m(2) and/or isolated proteinuria (≥1 + on urine dipstick) that persisted at month 3 after the baseline assessment. Risk factors associated with CKD were examined using univariate analysis and multivariate logistic regression analysis.
In total, 538 HIV-infected ART-naïve patients were included in this study. There were 399 male and 139 female patients. The mean age was 36.5 ± 10.0 years. The prevalence of hypertension, glycometabolism abnormities, and CKD were 3.2%, 3.0%, and 16.1%, respectively. Thirteen (2.4%) patients had estimated GFR (eGFR) < 60 mL/min per 1.73 m(2), while 73 (13.7%) patients had proteinuria. Using univariate analysis, CKD was found to be significantly (P < 0.05) associated with age, hypertension, HCV co-infection, and plasma HIV-1 viral load ≥ 100 000 copies/mL. In the multivariate logistic regression model, older age (increased by an interval of 10 years; P = 0.002), HCV co-infection (P = 0.039), and plasma HIV-1 viral load ≥ 100 000 copies/mL (P = 0.011) were significantly associated with CKD.
The incidence of CKD is high in Chinese HIV-infected ART-naïve patients. Traditional risk factors for renal disease, such as advancing age, HCV co-infection, and higher plasma viral load were correlated with CKD in the present patient samples.
本研究旨在评估中国内地初治抗反转录病毒治疗（ART）的 HIV 感染者中慢性肾脏病（CKD）的患病率和相关危险因素。
在这项多中心横断面研究中，使用肾脏病膳食改良试验（MDRD）方程计算肾小球滤过率（GFR）。CKD 的定义为 MDRD-GFR<60ml/min/1.73m²和/或在基线评估后 3 个月持续存在尿蛋白≥1+的孤立性蛋白尿。使用单因素分析和多因素 logistic 回归分析检查与 CKD 相关的危险因素。
本研究共纳入 538 例初治抗 HIV 治疗的 HIV 感染者。其中 399 例为男性，139 例为女性，平均年龄为 36.5±10.0 岁。高血压、糖代谢异常和 CKD 的患病率分别为 3.2%、3.0%和 16.1%。13 例（2.4%）患者估计肾小球滤过率（eGFR）<60ml/min/1.73m²，73 例（13.7%）患者有蛋白尿。单因素分析发现，CKD 与年龄、高血压、HCV 合并感染和血浆 HIV-1 病毒载量≥100000 拷贝/ml 显著相关（P<0.05）。多因素 logistic 回归模型显示，年龄较大（每增加 10 岁；P=0.002）、HCV 合并感染（P=0.039）和血浆 HIV-1 病毒载量≥100000 拷贝/ml（P=0.011）与 CKD 显著相关。
中国初治抗 HIV 治疗的 HIV 感染者 CKD 的发病率较高。在本患者样本中，传统的肾脏疾病危险因素，如年龄增长、HCV 合并感染和更高的血浆病毒载量与 CKD 相关。
