본문 바로가기
KERD
논문KCI 등재

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

김윤정|최윤수|최희정|최준용|송준영|최보율|안진영|박대원|장현하|김준명|최주연|위성헌|한명국|강춘|김은진|The Korea HIV/AIDS Cohort Study
대한감염학회 (The Korean Society Of Infectious Diseases)|2017.09|Infection and Chemotherapy|제49권 제3호|pp. 194-204

1

조회

0

다운로드

4

인용

0

참고문헌

키워드

PrevalenceHuman immunodeficiency virusRisk factorsRenal insufficiency
주제분류내과학

초록

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 m2, 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.

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 m2, 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.

참고문헌 (40)

  1. Valdiserri RO, "Commentary: thirty years of AIDS in America: a story of infinite hope", AIDS Educ Prev, 23, pp.479~494 (2011)
  2. Guaraldi G, "Premature age-related comorbidities among HIV-infected persons compared with the general population", Clin Infect Dis, 53, pp.1120~1126 (2011)
  3. Selik RM, "Trends in diseases reported on U.S. death certificates that mentioned HIV infection, 1987-1999", J Acquir Immune Defic Syndr, 29, pp.378~387 (2002)
  4. Smit M, "Future challenges for clinical care of an ageing population infected with HIV: a modelling study", Lancet Infect Dis, 15, pp.810~818 (2015)
  5. Smith CJ, "Trends in underlying causes of death in people with HIV from 1999 to 2011 (D:A:D): a multicohort collaboration", Lancet, 384, pp.241~248 (2014)
  6. GBD 2013 Mortality and Causes of Death Collaborators, "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990- 2013: a systematic analysis for the Global Burden of Disease Study 2013", Lancet, 385, pp.117~171 (2015)
  7. Santiago P, "Screening for decreased glomerular filtration rate and associated risk factors in a cohort of HIV-infected patients in a middle-income country", PLoS One, 9, pp.e93748~ (2014)
  8. Campos P, "HIV and kidney diseases: 35 years of history and consequences", Clin Kidney J, 9, pp.772~781 (2016)
  9. Ruggenenti P, "Progression, remission, regression of chronic renal diseases", Lancet, 357, pp.1601~1608 (2001)
  10. Gardner LI, "Development of proteinuria or elevated serum creatinine and mortality in HIV-infected women", J Acquir Immune Defic Syndr, 32, pp.203~209 (2003)
  11. Sackoff JE, "Causes of death among persons with AIDS in the era of highly active antiretroviral therapy: New York City", Ann Intern Med, 145, pp.397~406 (2006)
  12. Rao TK, "Associated focal and segmental glomerulosclerosis in the acquired immunodeficiency syndrome", N Engl J Med, 310, pp.669~673 (1984)
  13. Wyatt CM, "Acute renal failure in hospitalized patients with HIV: risk factors and impact on in-hospital mortality", AIDS, 20, pp.561~565 (2006)
  14. Mocroft A, "Cumulative and current exposure to potentially nephrotoxic antiretrovirals and development of chronic kidney disease in HIV-positive individuals with a normal baseline estimated glomerular filtration rate: a prospective international cohort study", Lancet HIV, 3, pp.e23~e32 (2016)
  15. Ryom L, "Predictors of advanced chronic kidney disease and end-stage renal disease in HIV-positive persons", AIDS, 28, pp.187~199 (2014)
  16. Jotwani V, "Risk factors for ESRD in HIV-infected individuals: traditional and HIV-related factors", Am J Kidney Dis, 59, pp.628~635 (2012)
  17. Stanifer JW, "The epidemiology of chronic kidney disease in sub-Saharan Africa: a systematic review and meta-analysis", Lancet Glob Health, 2, pp.e174~e181 (2014)
  18. Naicker S, "HIV and chronic kidney disease", Clin Nephrol, 83, pp.32~38 (2015)
  19. Diana NE, "Update on current management of chronic kidney disease in patients with HIV infection", Int J Nephrol Renovasc Dis, 9, pp.223~234 (2016)
  20. 김윤정, "Opportunistic diseases among HIV-infected patients: a multicenter-nationwide Korean HIV", AIDS cohort study, 2006 to 2013, 2016, pp.31(5), 953~960[DOI]
  21. Levey AS, "Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate", Ann Intern Med, 145, pp.247~254 (2006)
  22. Inker LA, "KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD", Am J Kidney Dis, 63, pp.713~735 (2014)
  23. Murray CJ, "Measuring the global burden of disease", N Engl J Med, 369, pp.448~457 (2013)
  24. Abraham AG, "North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) of the International Epidemiologic Databases to Evaluate AIDS (IeDEA). End-stage renal disease among HIV-infected adults in North America", Clin Infect Dis, 60, pp.941~949 (2015)
  25. Cheung CY, "Prevalence of chronic kidney disease in Chinese HIV-infected patients", Nephrol Dial Transplant, 22, pp.3186~3190 (2007)
  26. Coresh J, "Prevalence of chronic kidney disease in the United States", JAMA, 298, pp.2038~2047 (2007)
  27. 김성권, "The Prevalence of Chronic Kidney Disease (CKD) and the Associated Factors to CKD in Urban Korea: A Population-based Cross-sectional Epidemiologic Study", Journal of Korean Medical Science, 24, pp.11~21 (2009), 대한의학회
  28. Mocroft A, "Chronic renal failure among HIV-1-infected patients", AIDS, 21, pp.1119~1127 (2007)
  29. Sorlí ML, "Chronic kidney disease prevalence and risk factors among HIV-infected patients", J Acquir Immune Defic Syndr, 48, pp.506~508 (2008)
  30. Wyatt CM, "Chronic kidney disease in HIV infection: an urban epidemic", AIDS, 21, pp.2101~2103 (2007)
  31. Kasembeli AN, "APOL1 risk variants are strongly associated with HIV-associated nephropathy in black South Africans", J Am Soc Nephrol, 26, pp.2882~2890 (2015)
  32. Ulasi II, "High population frequencies of APOL1 risk variants are associated with increased prevalence of non-diabetic chronic kidney disease in the Igbo people from south-eastern Nigeria", Nephron Clin Pract, 123, pp.123~128 (2013)
  33. Yanagisawa N, "Clinical characteristics of kidney disease in Japanese HIV-infected patients", Nephron Clin Pract, 118, pp.c285~c291 (2011)
  34. Muramatsu T, "Prevalence of chronic kidney disease among HIV-infected individuals in Japan--a report from two tertiary hospitals", Kansenshogaku Zasshi, 87, pp.14~21 (2013)
  35. Kim SB, "Mathematical modeling of HIV prevention measures including pre-exposure prophylaxis on HIV incidence in South Korea", PLoS One, 9, pp.e90080~ (2014)
  36. Lee K, "Estimated glomerular filtration rate and albuminuria in Korean population evaluated for cardiovascular risk", Int Urol Nephrol, 48, pp.759~764 (2016)
  37. Achhra AC, "Kidney disease in antiretroviral-naive HIV-positive adults with high CD4 counts: prevalence and predictors of kidney disease at enrolment in the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial", HIV Med, 16(Suppl 1), pp.55~63 (2015)
  38. Fox CS, "Predictors of new-onset kidney disease in a community- based population", JAMA, 291, pp.844~850 (2004)
  39. Kalyesubula R, "Nephrotoxicity of HAART", AIDS Res Treat, 2011, pp.562790~ (2011)
  40. Fulop T, "Screening for chronic kidney disease in the ambulatory HIV population", Clin Nephrol, 73, pp.190~196 (2010)

관련 논문AI추천

The Incidence and Risk Factors of Renal Insufficiency among Korean HIV infected Patients: The Korea HIV/AIDS Cohort Study김상일, 송준영, Choi Bo Youl, Choi Jun Yong, Jang Heeseon, Kim Jung Ho, Kim Jun Hyoung, Kim Shin-Woo대한감염학회 · Infection and Chemotherapy2022 · 제54권 제3호HIV 감염 환자에서 고활성 항레트로바이러스 요법을 포함한 신기능 장애 위험인자 연구신형식, 여지영, 이유정, 진범식한국임상약학회 · 한국임상약학회지2012 · 제22권 제2호Incidence and risk factors for tenofovir-associated nephrotoxicity among human immunodeficiency virus-infected patients in Korea곽임수, 송상헌, 이선희, 이신원, 이정은대한내과학회 · The Korean Journal of Internal Medicine2019 · 제34권 제2호Change in Renal Function among HIV-Infected Koreans Receiving Tenofovir Disoproxil Fumarate-Backbone Antiretroviral Therapy: A 3-Year Follow-Up Study구남수, 김준명, 송영구, 이경화, 이지언, 정수진, 최준용, 한상훈연세대학교의과대학 · Yonsei Medical Journal2017 · 제58권 제4호Renal Disease in Persons Infected with Human Immunodeficiency Virus in Korea최평균대한감염학회 · Infection and Chemotherapy2017 · 제49권 제3호항레트로바이러스 치료를 받는 한국인 HIV 감염자에서 당뇨병 발생 양상김명수, 김준명, 김창오, 송영구, 이한성, 정수진, 진범식, 최석훈, 최준용, 최희경, 한상훈대한내과학회 · 대한내과학회지2008 · 제74권 제5호

이 간행물의 다른 논문 (13건)

Immunological Prediction of Cytomegalovirus (CMV) Replication Risk in Solid Organ Transplantation Recipients: Approaches for Regulating the Targeted Anti-CMV Prevention Strategies한상훈pp. 161-175Survey for Correlation between Biofilm Formation and Virulence Determinants in a Collection of Pathogenic and Fecal Enterococcus faecalis IsolatesShahla Mansouri, Fereshteh Saffari, Roya Ahmadrajabi, Mohammad Sadegh Dalfardipp. 176-183Antimicrobial Susceptibilities of Enterobacteriaceae in Community-Acquired Urinary Tract Infections during a 5-year Period: A Single Hospital Study in Korea이재갑, 서유빈, 박진주pp. 184-193Safety and Efficacy of Ziagen (Abacavir Sulfate) in HIV-Infected Korean Patients손장욱, 이진수, 김기현, 최영화, 김영근, 김신우, 한상훈, 이창섭, 박경화, 김연숙, 최현영, 윤나라, 장현하, 김계형, 이일섭, 안혜원pp. 205-212Causes of HIV Drug Non-Adherence in Korea: Korea HIV/AIDS Cohort Study, 2006-2015Korea HIV/AIDS Cohort Study, 강춘, 기미경, 김민정, 김효열, 김민자, 최주연, 김준명, 장현하, 우준희, 이상아, 최보율, 김상일, 송준영, 김신우, 최준용, 최윤수pp. 213-218
원문 보기