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Risk factors for kidney disease among HIV-1 positive persons in the methadone program

  • Bartłomiej Matłosz
  • Ewa Pietraszkiewicz
  • Ewa Firląg-Burkacka
  • Ewa Grycner
  • Andrzej Horban
  • Justyna D. Kowalska
Original article

Abstract

Background

Kidney injury is a serious comorbidity among HIV-infected patients. Intravenous drug use is listed as one of the risk factors for impaired renal function; however, this group is rarely assessed for specific renal-related risks.

Methods

Patients attending methadone program from 1994 to 2015 were included in the study. Data collected included demographic data, laboratory tests, antiretroviral treatment history, methadone dosing and drug abstinence. Patients’ drug abstinence was checked monthly on personnel demand. We have evaluated two study outcomes: (1) having at least one or (2) three eGFR < 60 ml/min (MDRD formula).

Results

In total, 267 persons, with 2593 person-years of follow-up were included into analyses. At the time of analyses, 251 (94%) were on antiretroviral therapy (ARV). Fifty-two (19.5%) patients had 1eGFR and 20 (7.5%) 3eGFR < 60. In univariate analysis, factors significantly increasing the odds of impaired renal function were: female gender, detectable HIV RNA on ART, age at registration per 5 years older, atazanavir use and time on antiretroviral treatment per 1 year longer. In the multivariate model, only female gender (OR 4.7; p = 0.002), time on cART (OR 1.11; p = 0.01) and baseline eGFR (OR 0.71; p = 0.001) were statistically significant.

Conclusions

We have demonstrated a high rate of kidney function impairment among HIV-1 positive patients in the methadone program. All risk factors for decreased eGFR in this subpopulation of patients were similar to those described for general HIV population with very high prevalence in women. These findings imply the need for more frequent kidney function monitoring in this subgroup of patients.

Keywords

Chronic kidney disease HIV Intravenous drug use Methadone 

Notes

Acknowledgements

This study was supported by the Research Development Foundation in Hospital for Infectious Diseases, Warsaw, Poland.

Compliance with ethical standards

Conflict of interest

The author(s) declare that they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted (IRB approval number AKBE/40/17) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Due to study design (retrospective analysis of the electronic database) informed consent is not required.

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Copyright information

© Japanese Society of Nephrology 2018

Authors and Affiliations

  • Bartłomiej Matłosz
    • 1
  • Ewa Pietraszkiewicz
    • 1
  • Ewa Firląg-Burkacka
    • 1
  • Ewa Grycner
    • 1
  • Andrzej Horban
    • 2
  • Justyna D. Kowalska
    • 1
    • 2
  1. 1.HIV Out-Patient ClinicHospital for Infectious DiseasesWarsawPoland
  2. 2.Department for Adults Infectious DiseasesMedical University of WarsawWarsawPoland

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