Prevalence of chronic kidney disease in Chinese HIV-infected patients

Background. To evaluate the prevalence of chronic kidney disease (CKD) in Chinese HIV-infected population. Methods. This was a cross-sectional point prevalence study. All Chinese HIV-infected patients who were followed up in a tertiary referral center in Hong Kong were recruited. Spot urine was saved for each patient to calculate urine protein-to-creatinine ratio (urine P/Cr). Those with urine P/Cr 0.3 would have 24-h urine collection to determine the exact amount of proteinuria. Glomerular filtration rate (GFR) was estimated using MDRD formula. CKD was defined as GFR 60ml/min/1.73m(2) and/or urine P/Cr 0.3. Baseline demographic and clinical data were extracted from patients records. Results. In total 322 patients were recruited. The mean age was 45.2 11.7 years. The duration of follow up was 6.0 4.0 years. There were 264 male and 58 female patients. The prevalence of hypertension, diabetes mellitus and CKD were 7.4, 10.6 and 16.8, respectively. Eighteen patients (5.6) had GFR 60ml/min/1.73m(2) while 44 patients (13.7) had spot urine P/Cr 0.3. Among those with urine P/Cr 0.3, 38 patients had 24-h urine collection. Using univariate analysis, CKD was found to be significantly (P = 0.05) associated with age, hypertension, diabetes, use of indinavir, lower CD4 count and peak viral load. Multivariate logistic regression revealed older age (P = 0.001), lower CD4 count (P = 0.02) and use of indinavir therapy (P = 0.04) were associated with development of CKD. Conclusion. CKD is prevalent in Chinese HIV-infected patients. Patients with CKD were more likely to be older, associated with use of indinavir and CD4 nadir less than 100 cells/l.