Increased risk of dialysis and end-stage renal disease among HIV patients in Denmark compared with the background population
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Increased risk of dialysis and end-stage renal disease among HIV patients in Denmark compared with the background population. / Rasch, Magnus G; Helleberg, Marie; Feldt-Rasmussen, Bo; Kronborg, Gitte; Larsen, Carsten S; Pedersen, Court; Pedersen, Gitte; Gerstoft, Jan; Obel, Niels.
I: Nephrology, Dialysis, Transplantation, Bind 29, Nr. 6, 06.2014, s. 1232-1238.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Increased risk of dialysis and end-stage renal disease among HIV patients in Denmark compared with the background population
AU - Rasch, Magnus G
AU - Helleberg, Marie
AU - Feldt-Rasmussen, Bo
AU - Kronborg, Gitte
AU - Larsen, Carsten S
AU - Pedersen, Court
AU - Pedersen, Gitte
AU - Gerstoft, Jan
AU - Obel, Niels
N1 - © The Author 2013. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.
PY - 2014/6
Y1 - 2014/6
N2 - BACKGROUND: HIV patients have increased risk of impaired renal function. We aimed to estimate the incidence of any renal replacement therapy (aRRT) and start of chronic renal replacement therapy (cRRT) among HIV patients compared with population controls.METHODS: In a nationwide, population-based cohort study we analysed incidence rates (IR), incidence rate ratios (IRR) and risk factors for aRRT and cRRT among HIV patients compared with an age- and gender-matched population control cohort using Poisson regression.RESULTS: We identified 5300 HIV patients and 53 000 population controls. The IRs per 10 000 person-years of aRRT and cRRT among HIV patients were 15.9 (95% CI: 12.5-20.1) and 4.4 (95% CI: 2.8-6.9), respectively. The IRR was 4.7 (95% CI: 3.5-6.2) for aRRT and 3.6 (95% CI: 2.2-6.0) for cRRT compared with population controls. Risk of aRRT was increased during the first year after HIV diagnosis [IRR 3.5 (95% CI: 1.5-8.1)], after a diagnosis of AIDS [IRR 2.3 (95% CI: 1.3-3.9)], in intravenous drug users [IRR 6.0 (95% CI: 2.9-12.2)] and in patients with hypertension [IRR 7.0 (95% CI: 3.7-13.2)]. Factors associated with increased risk of cRRT were hypertension [IRR 20 (95% CI: 6.8-61)] and baseline eGFR < 60 mL/min pr. 1.73 m(2) [IRR 7.8 (95% CI: 1.2-50)]. Exposure to tenofovir and/or atazanavir was not associated with risk of aRRT or cRRT.CONCLUSIONS: The risk of aRRT is increased more than 4-fold and the risk of cRRT is increased more than 3-fold in HIV patients in Denmark compared with the background population. We found no association between exposure to tenofovir, atazanavir or the combination of the two and risk of aRRT or cRRT.
AB - BACKGROUND: HIV patients have increased risk of impaired renal function. We aimed to estimate the incidence of any renal replacement therapy (aRRT) and start of chronic renal replacement therapy (cRRT) among HIV patients compared with population controls.METHODS: In a nationwide, population-based cohort study we analysed incidence rates (IR), incidence rate ratios (IRR) and risk factors for aRRT and cRRT among HIV patients compared with an age- and gender-matched population control cohort using Poisson regression.RESULTS: We identified 5300 HIV patients and 53 000 population controls. The IRs per 10 000 person-years of aRRT and cRRT among HIV patients were 15.9 (95% CI: 12.5-20.1) and 4.4 (95% CI: 2.8-6.9), respectively. The IRR was 4.7 (95% CI: 3.5-6.2) for aRRT and 3.6 (95% CI: 2.2-6.0) for cRRT compared with population controls. Risk of aRRT was increased during the first year after HIV diagnosis [IRR 3.5 (95% CI: 1.5-8.1)], after a diagnosis of AIDS [IRR 2.3 (95% CI: 1.3-3.9)], in intravenous drug users [IRR 6.0 (95% CI: 2.9-12.2)] and in patients with hypertension [IRR 7.0 (95% CI: 3.7-13.2)]. Factors associated with increased risk of cRRT were hypertension [IRR 20 (95% CI: 6.8-61)] and baseline eGFR < 60 mL/min pr. 1.73 m(2) [IRR 7.8 (95% CI: 1.2-50)]. Exposure to tenofovir and/or atazanavir was not associated with risk of aRRT or cRRT.CONCLUSIONS: The risk of aRRT is increased more than 4-fold and the risk of cRRT is increased more than 3-fold in HIV patients in Denmark compared with the background population. We found no association between exposure to tenofovir, atazanavir or the combination of the two and risk of aRRT or cRRT.
KW - Adenine
KW - Adult
KW - Anti-HIV Agents
KW - Cohort Studies
KW - Comorbidity
KW - Denmark
KW - Female
KW - HIV Infections
KW - Humans
KW - Incidence
KW - Kidney Failure, Chronic
KW - Male
KW - Middle Aged
KW - Oligopeptides
KW - Organophosphonates
KW - Pyridines
KW - Renal Dialysis
KW - Renal Replacement Therapy
KW - Risk Factors
U2 - 10.1093/ndt/gft289
DO - 10.1093/ndt/gft289
M3 - Journal article
C2 - 23975841
VL - 29
SP - 1232
EP - 1238
JO - Nephrology, Dialysis, Transplantation
JF - Nephrology, Dialysis, Transplantation
SN - 0931-0509
IS - 6
ER -
ID: 138503539