13th Annual Conference of the British HIV Association 29 March–1 April 2007, Brighton, UK

PREVALENCE, INCIDENCE AND AETIOLOGY OF CHRONIC RENAL FAILURE IN A COHORT OF HIV-INFECTED PATIENTS

HIV Med 2007; 8(Suppl. 1):7 (abstract no. O28)

Lucy Campbell, Elizabeth Tissingh, Philippa Easterbrook, Bruce Hendry and Frank Post
King’s College, London, UK

INTRODUCTION: Chronic renal failure (CRF) is an important complication of HIV infection yet remains poorly studied. We evaluated the prevalence, incidence and aetiology of CRF and risk factors for developing CRF in a large HIV cohort.

METHODS: All HIV+ patients with eGFR <60 (mL/min) for ≥3 months between 1/1998 and 12/2005 were reviewed.

RESULTS: Of 2034 HIV+ patients (female: 38%, Black: 55%, IVDU: 6%) with ≥3 months follow-up, 42 had eGFR <60 for ≥3 months. Renal failure was transient in six patients (predominant aetiology: drug toxicity) and persistent in 36 (CRF prevalence: 1.8%, aetiology: HIVAN, diabetes mellitus, hypertension/ reno-vascular disease, drug toxicity). Patients with CRF had poorer renal function at HIV diagnosis (median eGFR 47 versus 108, P<0.0001) and lower nadir CD4 counts (67 versus 214, P<0.0001) compared with 1824 patients with normal renal function. In 29 (81%) patients, renal disease was present at HIV diagnosis, and seven patients developed CRF a median of 623 days after HIV diagnosis (CRF incidence: 1.0/1000 person years). End-stage renal failure (ESRF) was diagnosed in 15 patients (0.7%); these patients had more severe renal disease (median eGFR 27 versus 64, P<0.001) at HIV diagnosis and more often HIVAN (67 versus 24%, P<0.001) compared with patients with CRF who did not develop ESRF.

CONCLUSION: CRF is relatively common in patients with newly diagnosed HIV infection and associated with advanced HIV infection. HIVAN is an important cause of CRF in patients not receiving HAART. Drug toxicity is an important cause of CRF and may affect kidney function at any stage of HIV infection. Renal function should be assessed by GFR estimation and urinalysis in all new patients.

2007-03-29
O28

Copyright © 2007 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD