scholarly journals Chronic Kidney Disease in a Large National Human Immunodeficiency Virus Treatment Program

2022 ◽  
Author(s):  
Ninutcha Paengsai ◽  
Kajohnsak Noppakun ◽  
Gonzague Jourdain ◽  
Tim R. Cressey ◽  
Nicolas Salvadori ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Real World ◽  
National Health Insurance System ◽  
Cd4 Cell Count ◽  
Asian Populations ◽  
National Human ◽  
Icd 10 ◽  
Incidence Of Ckd ◽  
Cd4 Cell

Abstract Introduction: Tenofovir disoproxil fumarate (TDF) is associated with a risk of chronic kidney disease (CKD), especially when used with protease inhibitors or in Asian populations. Data from the Thai national health insurance system were used to assess the incidence of CKD in patients receiving antiretroviral therapy (ART) in real-world practice. Materials and methods We analyzed data from patients who initiated one of the following first-line ART regimens: (i) zidovudine+lamivudine+nevirapine (AZT+3TC+NVP); (ii) zidovudine+lamivudine+efavirenz (AZT+3TC+EFV); (iii) tenofovir+lamivudine+nevirapine (TDF+3TC+NVP); (iv) tenofovir+lamivudine/emtricitabine+efavirenz (TDF+3TC/FTC+EFV); and (v) tenofovir+lamivudine+lopinavir/ritonavir (TDF+3TC+LPV/r). CKD was defined as glomerular filtration rate <60 mL/min/1.73 m2 for >3 months, or a confirmed 2010 WHO diagnosis (ICD-10 code N183, N184, or N185). Death competing risks survival regression models were used for the analysis. Results Among 27,313 participants, median age 36.8 years, body mass index 20.4 kg/m2, and absolute CD4 cell count 146 cells/mm3, followed for a median 2.3 years, 245 patients (0.9%) were diagnosed CKD (incidence 3.2 per 1,000 patient-years of follow-up; 95% confidence interval [CI] 2.8-3.6). Compared with patients receiving AZT+3TC+NVP, the risk of CKD measured by adjusted sub-distribution hazard ratio (aSHR) was higher in patients on TDF+3TC+LPV/r (6.5, 95% CI 3.9-11.1), on TDF+3TC+NVP (3.8, 95% CI 2.3-6.0) and on TDF+3TC/FTC+EFV (1.6, 95% CI 1.2-2.3). Among patients receiving TDF, compared with those receiving TDF+3TC/FTC+EFV, the risk was higher on TDF+3TC+LPV/r (4.0, 95%CI 2.3-6.8) on TDF+3TC+NVP (2.3, 95%CI 1.4-3.6) . Conclusions This real-world study suggest that the role of TDF in increasing the risk of CKD, especially when combined with LPV/r or NVP.

Incidence of renal Fanconi syndrome in patients taking antiretroviral therapy including tenofovir disoproxil fumarate

2017 ◽  
Vol 29 (3) ◽  
pp. 227-236 ◽  
Author(s):  
Nicholas A Medland ◽  
Eric PF Chow ◽  
Rowan G Walker ◽  
Marcus Chen ◽  
Tim RH Read ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tenofovir Disoproxil Fumarate ◽  
Fanconi Syndrome ◽  
Renal Fanconi Syndrome ◽  
Cd4 Cell Count ◽  
Length Of Treatment ◽  
Clinical Records ◽  
Cd4 Cell

The objective of this study was to determine the incidence and predictors of Fanconi Syndrome (FS) in a cohort of patients taking tenofovir disoproxil fumarate (TDF). Clinical records and laboratory investigations from patients receiving TDF between 2002 and 2016 were extracted. FS was defined as normoglycaemic glycosuria and proteinuria and at least one other marker of renal dysfunction. Regression analysis was performed with time to development of FS and the following covariates: ritonavir co-administration, age, gender, co-morbidities (hypertension, hyperlipidaemia, diabetes, viral hepatitis), CD4 cell count nadir and baseline eGFR. One thousand and forty-four patients received TDF without ritonavir and 398 patients with ritonavir. Thirteen cases of FS were identified with a mean duration of exposure of 55 months. The incidence of FS was 1.09/1000PY (0.54–1.63) of TDF exposure (without ritonavir) and 5.50/1000PY (3.66–7.33) of TDF-ritonavir co-administration (p=0.0057). The adjusted hazards ratio for ritonavir co-administration was 4.71 (1.37–16.14, p=0.014). Known risk factors for chronic kidney disease were not associated with development of FS. Ritonavir co-administration, but not other factors, is associated with a greater risk of FS. FS developed late. Known risk factors for chronic kidney disease and length of treatment are not useful for identifying patients most at risk of developing FS in patients taking TDF.

scholarly journals Association Between Chinese Herbal Medicine Therapy and the Risk of Chronic Kidney Disease in Gout Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Yan-Zhuan Xiao ◽  
Zhi-Zhong Ye ◽  
Yuan-Tong Liang ◽  
Xin-Peng Chen ◽  
Yu-Hsun Wang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Herbal Medicine ◽  
Chinese Herbal Medicine ◽  
Conditional Logistic Regression ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Research Database ◽  
Chinese Herbal ◽  
Incidence Of Ckd

Background: Chinese herbal medicine (CHM) has been nationally and globally used in treating gout for over a millennium. The potential relationship between the incidence of chronic kidney disease (CKD) in gout patients and CHM therapy is unclear. Thus, this study aimed to provide some evidence regarding the relationship between CHM therapy and the occurrence of CKD in gout patients.Methods: We used data from the National Health Insurance Research database (NHIRD) in Taiwan. In this population-based nested case-control study, all participants were identified by International Classification of Diseases, Ninth Revision (ICD-9). Conditional logistic regression was used to calculate the odds ratio (OR) of the risk of CKD in gout patients treated with CHM therapy.Results: Data on 1718 gout patients with CKD and 1:1 matched 1718 gout patients without CKD were collected for analysis. The results showed that CHM therapy in gout patients did not increase the risk of developing CKD (adjusted OR = 1.01; 95% confidence interval [CI]: 0.86–1.18; p &gt; 0.05). Moreover, CHM therapy in gout patients for &gt;365 days did not increase the incidence of CKD (adjusted OR = 1.30; 95% CI: 0.90–1.88; p = 0.162).Conclusion: Traditional CHM therapy does not increase the incidence of CKD in gout patients.

Elbasvir plus grazoprevir for patients with chronic hepatitis C genotype 1: A multicenter, real-world cohort study focusing on chronic kidney disease

2018 ◽  
Vol 159 ◽  
pp. 143-152 ◽  
Author(s):  
Eiichi Ogawa ◽  
Norihiro Furusyo ◽  
Koichi Azuma ◽  
Makoto Nakamuta ◽  
Hideyuki Nomura ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Chronic Hepatitis ◽  
Cohort Study ◽  
Hepatitis C ◽  
Kidney Disease ◽  
Chronic Hepatitis C ◽  
Real World ◽  
Genotype 1

Abstract 044: Cardiorespiratory Fitness May Explain a Proportion of Observed Racial Disparity in Incident Chronic Kidney Disease over 30 Years: Results From the CARDIA Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Amanda E Paluch ◽  
Lindsay Pool ◽  
Tamara Isakova ◽  
Myles Wolf ◽  
Rupal Mehta ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiorespiratory Fitness ◽  
Smoking Status ◽  
Healthy Eating Index ◽  
Rapid Decline ◽  
Parameter Estimates ◽  
Blacks And Whites ◽  
Incidence Of Ckd

Introduction: Racial and ethnic minorities are at higher risk for Chronic Kidney Disease (CKD). Higher levels of cardiorespiratory fitness (CRF) can reduce the risk of a rapid decline in estimated glomerular filtration rate (eGFR) and incidence of CKD. Little is known regarding how CRF contributes to racial disparities in CKD. Hypotheses: We hypothesized that: 1) baseline CRF is inversely associated with the risk of incident CKD after adjustment for covariates and 2) differences in baseline CRF account for a proportion of the disparity in incident CKD between blacks and whites. Methods: A total of 4328 young adults without CKD (age 24.8±3.6 years, 52.8% (n=2285) women, 51.9% (n=2247 black) completed a maximal graded treadmill test at baseline. We calculated eGFR using the CKD-EPI formula (baseline eGFR: 102.1±17.9 and 92.3±14.1 mL/minute/1.73 m 2 for blacks and whites, respectively). We defined CKD status as eGFR of <60 mL/minute/1.73 m 2 during 10, 15, 20, 25, and 30 year follow-up assessments. Multivariable Cox models examined hazard ratios (HR) and 95% confidence intervals (CI) for incidence of CKD. Models adjusted for baseline race, sex, age, field center, alcohol intake, smoking status, healthy eating index, eGFR, maximal educational attainment, and time-varying BMI, diabetes, and hypertension. The percent reduction in parameter estimates determined the excess risk explained according to CRF. Results: During the 30 years of follow-up, 84 blacks and 43 whites developed CKD. Every 1-minute lower treadmill duration associated with 12% higher rate of CKD (HR=1.12 (1.01-1.22)). Blacks were 1.89 times more likely to develop CKD compared to whites (HR=1.89 (1.23-2.91)). This was reduced to 1.75 (1.13-2.70) with CRF added to the model. This corresponds to a β reduction of 14.3% for race according to CRF. Conclusion: Both low fitness during young adulthood and black race are associated with higher incidence of CKD later in life. Fitness is a modifiable factor that could be targeted to address a portion of the disparity gap in CKD.

Association Between Dietary Diabetes Risk Reduction Score and Risk of Chronic Kidney Disease in Adults: Tehran Lipid and Glucose Study

2020 ◽  
Author(s):  
Parvin Mirmiran ◽  
Marjan Ramezan ◽  
Hossein Farhadnejad ◽  
Golaleh Asghari ◽  
Zhaleh Tahmasebinejad ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Risk Reduction ◽  
Smoking Status ◽  
Adult Population ◽  
Diabetes Risk ◽  
Study Population ◽  
Incidence Of Ckd ◽  
Cox Proportional Hazard Regression ◽  
Incident Cases

Abstract Background: To examine the association of dietary diabetes risk reduction score (DDRRS) with chronic kidney disease (CKD) among an Iranian population.Methods: We followed-up 2076 ≥ 20 years old participants of Tehran Lipid and Glucose Study (2006-2008), who were initially free of CKD for 5.98 years. Dietary diabetes risk reduction score was calculated on the basis of scoring eight components using a valid and reliable 168-item food frequency questionnaire. CKD was defined as eGFR<60 mL/min/1.73 m2.A Cox proportional hazard regression model was used to assess association between the quartiles of DDRRS and incidence of CKD.Results: Mean±SD age of the study population (53% women) was 37.6±12.61 years. A total of 357 incident cases of CKD were reported. The median (25-75 interquartile range) of DDRRS was 20 (18-22). After adjustment for age, sex, smoking status, total energy intake, body mass index, hypertension, diabetes, eGFR, and physical activity, individuals in the highest versus lowest quartile of DDRRS were 33% less likely to have CKD (OR: 0.67; 95% CI: 0.48-0.96, P for trend: 0.043).Conclusion: Our findings suggest that higher adherence to the DDRRS-style diet can decrease the risk of incident CKD in adult population.

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