HIV Outpatient Clinic, Hospital for Infectious Diseases, Medical University of Warsaw, 02-091 Warszawa, Poland.
Department of Adults' Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, 02-091 Warszawa, Poland.
Int J Environ Res Public Health. 2022 Oct 1;19(19):12554. doi: 10.3390/ijerph191912554.
Chronic kidney disease (CKD) is a significant cause of morbidity and mortality among patients infected with human immunodeficiency virus (HIV). The Central and East Europe (CEE) region consists of countries with highly diversified HIV epidemics, health care systems and socioeconomic status. The aim of the present study was to describe variations in CKD burden and care between countries. The Euroguidelines in the CEE Network Group includes 19 countries and was initiated to improve the standard of care for HIV infection in the region. Information on kidney care in HIV-positive patients was collected through online surveys sent to all members of the Network Group. Almost all centres use regular screening for CKD in all HIV (+) patients. Basic diagnostic tests for kidney function are available in the majority of centres. The most commonly used method for eGFR calculation is the Cockcroft-Gault equation. Nephrology consultation is available in all centres. The median frequency of CKD was 5% and the main cause was comorbidity. Haemodialysis was the only modality of treatment for kidney failure available in all ECEE countries. Only 39% of centres declared that all treatment options are available for HIV+ patients. The most commonly indicated barrier in kidney care was patients' noncompliance. In the CEE region, people living with HIV have full access to screening for kidney disease but there are important limitations in treatment. The choice of dialysis modality and access to kidney transplantation are limited. The main burden of kidney disease is unrelated to HIV infection. Patient care can be significantly improved by addressing noncompliance.
慢性肾脏病（CKD）是感染人类免疫缺陷病毒（HIV）的患者发病率和死亡率的重要原因。中东欧（CEE）地区由具有高度多样化 HIV 流行情况、医疗保健系统和社会经济地位的国家组成。本研究的目的是描述各国之间 CKD 负担和护理的差异。CEE 网络小组中的 Euroguidelines 包括 19 个国家，旨在提高该地区 HIV 感染护理的标准。通过向网络小组的所有成员发送在线调查，收集了有关 HIV 阳性患者肾脏护理的信息。几乎所有中心都对所有 HIV（+）患者进行常规 CKD 筛查。大多数中心都可以进行肾功能基本诊断测试。最常用的 eGFR 计算方法是 Cockcroft-Gault 方程。所有中心都可以进行肾病咨询。CKD 的中位频率为 5%，主要病因是合并症。血液透析是所有中东欧国家唯一可用的肾脏衰竭治疗方法。只有 39%的中心表示所有治疗方案都可用于 HIV+患者。在肾脏护理中最常被指出的障碍是患者不遵医嘱。在 CEE 地区，HIV 感染者可以完全获得肾脏疾病的筛查，但在治疗方面存在重要限制。透析方式的选择和肾脏移植的机会有限。肾脏疾病的主要负担与 HIV 感染无关。通过解决不遵医嘱的问题，可以显著改善患者护理。
