Lopez Edgar Dehesa, Córdova-Cázarez Carlos, Valdez-Ortiz Rafael, Cardona-Landeros Carlie Michelle, Gutiérrez-Rico María Fernanda
Hospital Civil de Culiacan, Centro de Investigación y Docencia en Ciencias de la Salud, Culiacan, Sinaloa, Mexico.
Instituto Mexicano del Seguro Social, Culiacan, Sinaloa, Mexico.
J Bras Nefrol. 2019 Jan-Mar;41(1):48-54. doi: 10.1590/2175-8239-jbn-2018-0024. Epub 2018 Jul 10.
To determine the prevalence of chronic kidney disease (CKD) and the epidemiological, clinical, and laboratory factors associated with CKD in Mexican HIV-infected patients.
Cross-sectional study. We included 274 patients with HIV/AIDS. CKD was defined by the estimated glomerular filtration rate (eGFR < 60 mL/min/1.73 m2 assessed by CKD-EPI) and albuminuria criteria from KDIGO guidelines. Clinical, epidemiological, and laboratory characteristics were compared between patients with and without CKD. The factors associated with CKD were assessed by logistic regression analysis.
The mean age was 41±11 years, and 72.3% of the patients were men. The global prevalence of CKD was 11.7% (n = 32); 7.2% (n = 20) were defined by eGFR criterion; 7.6% (n = 21), by the albuminuria criterion; and 3.2% (n = 9), by both CKD criteria. The most frequently observed stages of CKD were KDIGO G3A1 stage with 4.7% (n = 13), KDIGO G1A2 stage with 3.6% (n = 10) and KDIGO G3A2 stage with 1.7% (n = 5). The factors associated with CKD were use of abacavir/lamivudine (OR 3.2; 95% CI 1.1-8.9; p = 0.03), a CD4 lymphocyte count < 400 cells/µL (OR 2.6; 95% 1.03-6.4, p = 0.04), age (OR 1.1; 95% CI 1.04-1.2, p = 0.001) and albuminuria (OR 19.98; 95% CI: 5.5-72.2; p < 0.001).
CKD was a frequent complication in HIV-infected patients. These findings confirm the importance of screening and the early detection of CKD, as well as the importance of identifying and treating traditional and non-traditional risk factors associated with CKD.
确定墨西哥艾滋病病毒感染患者中慢性肾脏病（CKD）的患病率以及与CKD相关的流行病学、临床和实验室因素。
横断面研究。我们纳入了274例艾滋病病毒/艾滋病患者。CKD根据估计肾小球滤过率（采用CKD-EPI评估的eGFR<60 mL/min/1.73 m²）和KDIGO指南中的白蛋白尿标准来定义。对患有和未患有CKD的患者的临床、流行病学和实验室特征进行比较。通过逻辑回归分析评估与CKD相关的因素。
平均年龄为41±11岁，72.3%的患者为男性。CKD的总体患病率为11.7%（n = 32）；7.2%（n = 20）根据eGFR标准定义；7.6%（n = 21）根据白蛋白尿标准定义；3.2%（n = 9）根据两种CKD标准定义。最常观察到的CKD分期为KDIGO G3A1期，占4.7%（n = 13）；KDIGO G1A2期，占3.6%（n = 10）；KDIGO G3A2期，占1.7%（n = 5）。与CKD相关的因素有使用阿巴卡韦/拉米夫定（比值比3.2；95%置信区间1.1 - 8.9；p = 0.03）、CD4淋巴细胞计数<400个细胞/µL（比值比2.6；95% 1.03 - 6.4，p = 0.04）、年龄（比值比1.1；95%置信区间1.04 - 1.2，p = 0.001）和白蛋白尿（比值比19.98；95%置信区间：5.5 - 72.2；p < 0.001）。
CKD是艾滋病病毒感染患者中常见的并发症。这些结果证实了筛查和早期发现CKD的重要性，以及识别和治疗与CKD相关的传统和非传统危险因素的重要性。
