DOI 10.5414/CN107668

Clinical Nephrology, Volume 79 (2013) - May (362 - 369)

Impact of cystatin C elevation and albuminuria on probability of adverse outcomes in HIV-infected men receiving HAART

Naoki Yanagisawa, Minoru Ando, Ken Tsuchiya, Kosaku Nitta
Department IV of Internal Medicine, Tokyo Women’s Medical University, Kawada-cho, Shinjuku-ku, Tokyo, Japan

Abstract

Background: Highly active antiretroviral therapy (HAART) has contributed to the longevity of human immunodeficiency virus (HIV)-infected patients; however, improved survival has been accompanied by an increase in the prevalence of kidney disease. Kidney disease may be partly responsible for higher morbidity in HIV-infected patients than in HIV-uninfected subjects. Methods: A total of 515 well-controlled HIVinfected men on HAART was enrolled in a 3-year prospective cohort study. The incidence of cancer and CVD was investigated over time. The impact of cystatin C elevation and albuminuria at baseline on the incidence of each disease was examined. Albuminuria was estimated by determining the albuminto-creatinine ratio (ACR). The cumulative incidence of cancer and CVD was analyzed using the Kaplan-Meier method, stratified by the presence and absence of elevated cystatin C and albuminuria biomarkers. Cox proportional hazards analysis was used to calculate the hazards ratio (HR) and 95% incidence interval (CI) of each biomarker, adjusted for known risk factors. Results: All participants completed the 3-year follow-up study. During the follow-up period, cancers and CVD developed in 13 (2.5%) and 14 (2.7%) participants, respectively. The Kaplan-Meier estimates were significantly increased for cancer incidence in patients with cystatin C elevation and for CVD in those with albuminuria. The HR (95% CI) of cystatin C elevation for occurrence of cancer was 6.09 (1.30 – 24.6) and the HR (95% CI) of ACR ≥ 20 mg/g for CVD was 8.97 (2.20 – 60.8). Conclusions: Cystatin C elevation and/or albuminuria at baseline in HIV-infected men undergoing HAART may be associated with poor prognosis.

Author Details

Authors

  • Naoki Yanagisawa
  • Minoru Ando
  • Ken Tsuchiya
  • Kosaku Nitta

Departments

  • Department IV of Internal Medicine, Tokyo Women’s Medical University, Kawada-cho, Shinjuku-ku, Tokyo, Japan

Full Text

Add to Cart

Rights / Permissions

This section will be available soon


Shopping Overview
Type Qtty Price
Your basket is empty
View Cart