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The Prevalence and Risk Factors of Renal Insufficiency among Korean HIV-Infected Patients: The Korea HIV/AIDS Cohort Study

Authors
Kim, Eun JinAhn, Jin YoungKim, Youn JeongWie, Seong-HeonPark, Dae WonSong, Joon-YoungChoi, Hee JungChang, Hyun-HaChoi, Bo YoulChoi, YunsuChoi, Ju-yeonHan, Myung GukKang, ChunKim, June MyungChoi, Jun Yong
Issue Date
9월-2017
Publisher
KOREAN SOC CHEMOTHERAPY
Keywords
Human immu-nodeficiency virus; Renal insufficiency; Prevalence; Risk factors
Citation
INFECTION AND CHEMOTHERAPY, v.49, no.3, pp.194 - 204
Indexed
SCOPUS
KCI
Journal Title
INFECTION AND CHEMOTHERAPY
Volume
49
Number
3
Start Page
194
End Page
204
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/82366
DOI
10.3947/ic.2017.49.3.194
ISSN
2093-2340
Abstract
Background: Renal disease is one of the leading causes of morbidity and mortality among people infected with human immunodeficiency virus (HIV). However, there are very few published studies about renal insufficiency in HIV-infected persons in Asia, especially in South Korea. Materials and Methods: A cross-sectional study was performed to investigate the prevalence and risk factors of renal insufficiency, defined as <60 mL/min/1.73 m(2), in subjects in the Korea HIV/AIDS Cohort Study enrolled from 19 institutions between December 2006 and July 2013. Data at entry into the cohort were analyzed. Results: Of 454 enrolled subjects, 24 (5.3%) showed renal insufficiency at entry into the cohort. The mean age of patients in the renal insufficiency group was 5.28 years and the majority were male subjects (91.7%). All the patients were receiving antiretroviral agents, mostly protease inhibitor-based regimens (76.4%), for an average of 19 months. In univariate analysis, older age (P = 0.002), diabetes mellitus (DM) (P = 0.0002), unknown route of transmission (P = 0.007), and taking indinavir (P = 0.0022) were associated with renal insufficiency. In multivariable analysis, older age [odds ratio (OR) 1.07, 95% confidence interval (CI) 1.03-1.12, P = 0.002], DM [OR 3.03, 95% CI 1.17-7.82, P = 0.022], unknown route of transmission [OR 6.15, 95% CI 1.77-21.33, P = 0.004], and taking indinavir [OR 3.07, 95% CI 1.17-8.05, P = 0.023] were independent risk factors of renal insufficiency. Conclusion: The prevalence of renal insufficiency in HIV-infected subjects in this study was relatively low, similar to that in other countries. Aging, DM, and taking indinavir were significantly associated with decreased glomerular filtration rate. Furthermore, unknown route of transmission was an independent risk factor, which was interpreted as a reflection of patient compliance. Further studies on the incidence and risk factors of renal insufficiency during HIV infection using follow-up cohort data are necessary.
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