The Impact of Immunosuppression on Chronic Kidney Disease in People Living With Human Immunodeficiency Virus: The D:A:D Study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Lene Ryom
  • Lundgren, Jens
  • Peter Reiss
  • Mike Ross
  • Kirk, Ole
  • Christophe A Fux
  • Phillipe Morlat
  • Eric Fontas
  • Colette Smith
  • Stephane De Wit
  • Antonella D’arminio Monforte
  • Wafaa El Sadr
  • Camilla Hatleberg
  • Andrew Phillips
  • Caroline Sabin
  • Matthew Law
  • Amanda Mocroft
Relations between different measures of human immunodeficiency virus–related immunosuppression and chronic kidney disease (CKD) remain unknown.

Immunosuppression measures included baseline, current, time-lagged and nadir CD4, years and percentage of follow-up (%FU) with CD4 ≤200 cells/μL, and CD4 recovery. CKD was defined as confirmed estimated glomerular filtration rate <60 mL/minute/1.73 m2.

Of 33 791 persons, 2226 developed CKD. Univariably, all immunosuppression measures predicted CKD. Multivariably, the strongest predictor was %FU CD4 ≤200 cells/μL (0 vs >25%; incidence rate ratio [IRR], 0.77 [95% confidence interval [CI], .68–.88]), with highest effect in those at low D:A:D CKD risk (IRR, 0.45 [95% CI, .24–.80]) vs 0.80 [95% CI, .70–.93]).

Longer immunosuppression duration most strongly predicts CKD and affects persons at low CKD risk more.
TidsskriftThe Journal of Infectious Diseases
Udgave nummer4
Sider (fra-til)632-637
Antal sider6
StatusUdgivet - 24 feb. 2021

ID: 279828252