The Impact of Immunosuppression on Chronic Kidney Disease in People Living With Human Immunodeficiency Virus: The D:A:D Study
Research output: Contribution to journal › Journal article › Research › peer-review
Background
Relations between different measures of human immunodeficiency virus–related immunosuppression and chronic kidney disease (CKD) remain unknown.
Methods
Immunosuppression measures included baseline, current, time-lagged and nadir CD4, years and percentage of follow-up (%FU) with CD4 ≤200 cells/μL, and CD4 recovery. CKD was defined as confirmed estimated glomerular filtration rate <60 mL/minute/1.73 m2.
Results
Of 33 791 persons, 2226 developed CKD. Univariably, all immunosuppression measures predicted CKD. Multivariably, the strongest predictor was %FU CD4 ≤200 cells/μL (0 vs >25%; incidence rate ratio [IRR], 0.77 [95% confidence interval [CI], .68–.88]), with highest effect in those at low D:A:D CKD risk (IRR, 0.45 [95% CI, .24–.80]) vs 0.80 [95% CI, .70–.93]).
Conclusions
Longer immunosuppression duration most strongly predicts CKD and affects persons at low CKD risk more.
Relations between different measures of human immunodeficiency virus–related immunosuppression and chronic kidney disease (CKD) remain unknown.
Methods
Immunosuppression measures included baseline, current, time-lagged and nadir CD4, years and percentage of follow-up (%FU) with CD4 ≤200 cells/μL, and CD4 recovery. CKD was defined as confirmed estimated glomerular filtration rate <60 mL/minute/1.73 m2.
Results
Of 33 791 persons, 2226 developed CKD. Univariably, all immunosuppression measures predicted CKD. Multivariably, the strongest predictor was %FU CD4 ≤200 cells/μL (0 vs >25%; incidence rate ratio [IRR], 0.77 [95% confidence interval [CI], .68–.88]), with highest effect in those at low D:A:D CKD risk (IRR, 0.45 [95% CI, .24–.80]) vs 0.80 [95% CI, .70–.93]).
Conclusions
Longer immunosuppression duration most strongly predicts CKD and affects persons at low CKD risk more.
Original language | English |
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Journal | The Journal of Infectious Diseases |
Volume | 223 |
Issue number | 4 |
Pages (from-to) | 632-637 |
Number of pages | 6 |
ISSN | 0022-1899 |
DOIs | |
Publication status | Published - 24 Feb 2021 |
Links
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7904289/pdf/jiaa396.pdf
Final published version
ID: 279828252