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37岁以上的HIV感染患者应密切监测估算肾小球滤过率(eGFR)。

Close Monitoring of eGFR Should Be Performed in HIV-Infected Patients Aged over 37 Years.

作者信息

Limkunakul Chutatip, Srinithiwat Palakorn, Lochinda Busaraporn, Sawanyawisuth Kittisak

机构信息

Department of Medicine, Srinakharinwirot University.

Department of Nursing, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University.

出版信息

Jpn J Infect Dis. 2017 Nov 22;70(6):656-659. doi: 10.7883/yoken.JJID.2016.370. Epub 2017 Sep 11.

Abstract

Chronic kidney disease (CKD) has been shown to be a poor prognostic factor in HIV patients. This study aimed to identify risk factors in HIV-infected patients with early decline in renal function or an estimated glomerular filtration rate (eGFR) less than 90 mL/min/1.73 m. The study was retrospectively conducted at Panyananthaphikkhu Chonprathan Medical Center, Thailand. The inclusion criteria were HIV-infected adult patients who were treated at the hospital's HIV clinic and whose eGFR levels at the first visit had been evaluated. Eligible patients were categorized according to their eGFR level being lesser or greater than 90 mL/min/1.73 m. Multivariate logistic analysis was performed to evaluate the association of risk factors with an eGFR of less than 90 mL/min/1.73 m. There were 301 HIV-infected patients included in the study. Of those, 89 patients (29.57%) had an eGFR of less than 90 mL/min/1.73 m. Age was the only significant risk factor associated with an eGFR of less than 90 mL/min/1.73 m with an adjusted odds ratio of 1.072 (95% confidence interval: 1.015-1.132). Age of over 37 years predicted an eGFR of less than 90 mL/min/1.73 m as a risk factor in HIV-infected patients, with a sensitivity of 80.9% and specificity of 34.91%. Age was independently associated with eGFRs of less than 90 mL/min/1.73 m in HIV-infected patients. Close monitoring of eGFR should be performed in HIV-infected patients aged over 37 years.

摘要

慢性肾脏病(CKD)已被证明是HIV患者预后不良的一个因素。本研究旨在确定肾功能早期下降或估算肾小球滤过率(eGFR)低于90 mL/min/1.73 m²的HIV感染患者的危险因素。该研究在泰国春蓬府巴尼亚南塔皮库医院进行回顾性研究。纳入标准为在该医院HIV门诊接受治疗且首次就诊时已评估eGFR水平的成年HIV感染患者。符合条件的患者根据其eGFR水平是否低于90 mL/min/1.73 m²进行分类。采用多因素logistic分析评估危险因素与eGFR低于90 mL/min/1.73 m²之间的关联。本研究共纳入301例HIV感染患者。其中,89例(29.57%)患者的eGFR低于90 mL/min/1.73 m²。年龄是与eGFR低于90 mL/min/1.73 m²相关的唯一显著危险因素,校正比值比为1.072(95%置信区间:1.015 - 1.132)。37岁以上年龄预测HIV感染患者eGFR低于90 mL/min/1.73 m²为危险因素,敏感度为80.9%,特异度为34.91%。年龄与HIV感染患者eGFR低于90 mL/min/1.73 m²独立相关。对37岁以上的HIV感染患者应密切监测其eGFR。

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