Infect Chemother.  2017 Sep;49(3):194-204. 10.3947/ic.2017.49.3.194.

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

• Kim EJ
• Ahn JY
• Kim YJ
• Wie SH
• Park DW
• Song JY
• Choi HJ
• Chang HH
• Choi BY
• Choi Y
• Choi JY
• Han MG
• Kang C
• Kim JM
• Choi JY
• The Korea HIV/AIDS Cohort Study

• KMID: 2391425
• DOI: http://doi.org/10.3947/ic.2017.49.3.194

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.
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.

Keyword

Human immunodeficiency virus; Renal insufficiency; Prevalence; Risk factors

MeSH Terms

Aging
Anti-Retroviral Agents
Asia
Cohort Studies*
Cross-Sectional Studies
Diabetes Mellitus
Follow-Up Studies
Glomerular Filtration Rate
HIV
HIV Infections
Humans
Incidence
Indinavir
Korea*
Male
Mortality
Patient Compliance
Prevalence*
Renal Insufficiency*
Risk Factors*
Anti-Retroviral Agents
Indinavir

Figure

• 

  Figure 1 Exclusion criteria of study population HIV, human immunodeficiency virus; RNA, ribonucleic acid; ART, antiretroviral treatment.

• 

  Figure 2 Cumulative numbers of renal insufficiency cases in Korean HIV-infected patients for each year of the study

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