Details

Autor(en) / Beteiligte

• Herbas Ekat, Martin
• Tidiane Ndour, Cheikh
• Bienvenue Ossibi Ibara, Roland
• Diafouka, Merlin
• Boumandoki, Paul
• Adoua Doukaga, Tatia
• Axel Aloumba, Gilius
• Mahambou-Nsonde, Dominique
• Roger Nzounza, Patrick
• Obengui, Pani
• Seydi, Moussa

Titel

Low Body Mass Index and impact of antiretroviral therapy on nephrotoxicity, chronic renal disease among HIV-infected patients in Brazzaville, Congo

Ist Teil von

• Néphrologie & thérapeutique, 2020-03, Vol.16 (2), p.97

Ort / Verlag

France

Erscheinungsjahr

2020

Quelle

MEDLINE

Beschreibungen/Notizen

• To describe the incidence and risks factors of ART induced nephrotoxicity and chronic kidney disease in HIV-1-infected adults with low body mass index (<18.5kg/m ). A retrospective cohort study at the Ambulatory Treatment Center in Brazzaville, Congo. Patients with estimated glomerular filtration rate decrease by 25% compared to baseline or a 0.5mg/dL increase in serum creatinine above baseline were classified as having nephrotoxicity, and chronic kidney disease was defined as a value less than 60mL/min/1.73m . We used Cox proportional hazards regression models to determine factors associated with nephrotoxicity and chronic kidney disease. Of 325 patients, 73.23% were women. Median values were an age 37.55 years (IQR: 33.51-44.96), weight 45kg (IQR: 41-49), CD4 count 137.5 cells/μL (42-245). In the first 24-months, follow-up on ART incidence rate of nephrotoxicity and chronic kidney disease was 27.95 and 7.44 per 100 persons-year respectively. Multivariate analysis identified as a risk factor of nephrotoxicity, baseline haemoglobin below or equal 8g/dL (aHR=2.25; 95%CI 1.28-3.98; P=0.005) and the use of tenofovir (aHR=1.51; 95%CI 1.01-2.27; P=0.04). DFG between 60-80 mL/min/1.73 m2 (aHR=0.35; 95%CI 0.21-0.59; P<0.001) and 45-59mL/min/1.73 m (aHR=0.10; 95%CI 0.01-0.72; P=0.02) was not a contraindication for initiating antiretroviral therapy. Each 10-year older age was associated with an increased risk of developing chronic kidney disease (aHR=1.95; 95%CI 1.2-3.17; P=0.007). Incidence of nephrotoxicity and chronic kidney disease were high. African HIV-positive patient with low body mass index at baseline need close monitoring of their renal function when treated with tenofovir.