1 research outputs found
Supplementary Material for: Absence of Decline of Kidney Function in Human Immunodeficiency Virus-Infected Patients Under Routine Clinical Management
<p><b><i>Background:</i></b> Since the introduction of antiretroviral
therapy (ART), human immunodeficiency virus (HIV)-infected patients have
a drastically improved prognosis but at the same time they are also
more affected by non-HIV related complications, such as chronic kidney
disease. The objective of our study was to investigate the effect of
proteinuria and tenofovir (TDF)-containing ART regimens on the temporal
evolution of estimated glomerular filtration rate (eGFR). <b><i>Methods:</i></b>
Between April 2008 and October 2012, we enrolled 395 patients with a
complete renal evaluation among patients from the ANRS C03 Aquitaine
cohort, a prospective hospital-based cohort of HIV-1-infected patients
under routine clinical management in southwestern France. eGFR was
estimated at each patient follow-up visit. A linear mixed model was used
to analyze eGFR dynamics, accounting for change in TDF by modeling eGFR
trajectory according to treatment periods. <b><i>Results:</i></b> At
inclusion, 56.7% of patients were treated with TDF-containing ART
regimens; prevalence of glomerular and tubular proteinuria was 7.9 and
10.8% respectively. A 1-year increase of cumulative exposure to TDF was
significantly associated with a mean eGFR decrease of 1.27 mL/min/1.73 m<sup>2</sup>
(95% CI [-2.14 to -0.41]). Only a urine protein to creatinine ratio
>100 mg/mmol and/or a urine albumin to creatinine ratio >70
mg/mmol were associated with eGFR trajectory (mean slope 6.18
mL/min/1.73 m<sup>2</sup> per year; 95% CI [2.71 to 9.65]), whereas TDF use was not associated with such eGFR temporal evolution. <b><i>Conclusion:</i></b>
Decline in kidney function is limited under routine clinical management
with monitoring of renal function and interventions including decision
to continue or discontinue TDF.</p