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The Impact of Immunosuppression on Chronic Kidney Disease in People Living With Human Immunodeficiency Virus: The D:A:D Study

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@article{442dc179b9ba484b83a7cf6017a49571,
title = "The Impact of Immunosuppression on Chronic Kidney Disease in People Living With Human Immunodeficiency Virus: The D:A:D Study",
abstract = "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.",
keywords = "CD4, chronic kidney disease, CKD, eGFR, HIV, immunosuppression, renal",
author = "L Ryom and Lundgren, {J D} and P Reiss and M Ross and O Kirk and Fux, {C A} and P Morlat and E Fontas and C Smith and {De Wit}, S and {d'Arminio Monforte}, A and {El Sadr}, W and C Hatleberg and A Phillips and C Sabin and M Law and A Mocroft and {D:A:D study group}",
note = "{\textcopyright} The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.",
year = "2021",
month = feb,
day = "15",
doi = "10.1093/infdis/jiaa396",
language = "English",
volume = "223",
pages = "632--637",
journal = "Journal of Infectious Diseases",
issn = "0022-1899",
publisher = "University of Chicago Press",
number = "4",

}

RIS

TY - JOUR

T1 - The Impact of Immunosuppression on Chronic Kidney Disease in People Living With Human Immunodeficiency Virus

T2 - The D:A:D Study

AU - Ryom, L

AU - Lundgren, J D

AU - Reiss, P

AU - Ross, M

AU - Kirk, O

AU - Fux, C A

AU - Morlat, P

AU - Fontas, E

AU - Smith, C

AU - De Wit, S

AU - d'Arminio Monforte, A

AU - El Sadr, W

AU - Hatleberg, C

AU - Phillips, A

AU - Sabin, C

AU - Law, M

AU - Mocroft, A

AU - D:A:D study group

N1 - © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

PY - 2021/2/15

Y1 - 2021/2/15

N2 - 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.

AB - 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.

KW - CD4

KW - chronic kidney disease

KW - CKD

KW - eGFR

KW - HIV

KW - immunosuppression

KW - renal

UR - http://www.scopus.com/inward/record.url?scp=85102322122&partnerID=8YFLogxK

U2 - 10.1093/infdis/jiaa396

DO - 10.1093/infdis/jiaa396

M3 - Journal article

C2 - 32640015

VL - 223

SP - 632

EP - 637

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

SN - 0022-1899

IS - 4

ER -

ID: 60480388