Spectrum of chronic kidney disease in HIV-infected patients

HIV Med. 2009 Jul;10(6):329-36. doi: 10.1111/j.1468-1293.2008.00691.x. Epub 2009 Feb 15.


Objectives: The aim of the study was to investigate the prevalence and aetiology of chronic kidney disease (CKD) and trends in estimated glomerular filtration rate (eGFR) in HIV-infected patients.

Methods: Ascertainment and review of CKD cases among patients attending King's College and Brighton Hospitals, UK were carried out. CKD was defined as eGFR <60 mL/min for > or =3 months. Longitudinal eGFR slopes were produced to examine trends in renal function before, during and after exposure to indinavir (IDV) or tenofovir (TFV).

Results: CKD prevalence was 2.4%. While HIV-associated nephropathy accounted for 62% of CKD in black patients, 95% of CKD in white/other patients was associated with diabetes mellitus, hypertension, atherosclerosis and/or drug toxicity. Exposure to IDV or TFV was associated with an accelerated decline in renal function (4.6-fold and 3.7-fold, respectively) in patients with CKD. In patients initiating IDV, age > or =50 years increased the odds of CKD [odds ratio (OR) 4.9], while in patients initiating TFV, age > or =50 years (OR 5.4) and eGFR 60-75 mL/min (OR 17.2) were associated with developing CKD.

Conclusion: This study highlights the importance of metabolic and vascular disease to the burden of CKD in an ageing HIV-infected cohort. In patients who developed CKD, treatment with IDV or TFV was associated with an accelerated decline in renal function.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Associated Nephropathy / chemically induced*
  • AIDS-Associated Nephropathy / epidemiology
  • AIDS-Associated Nephropathy / ethnology
  • Adenine / adverse effects
  • Adenine / analogs & derivatives*
  • Adult
  • Age Factors
  • Analysis of Variance
  • Anti-HIV Agents / adverse effects*
  • Female
  • Glomerular Filtration Rate / physiology
  • HIV-1*
  • Humans
  • Indinavir / adverse effects*
  • Kidney Failure, Chronic / chemically induced*
  • Kidney Failure, Chronic / epidemiology
  • Kidney Failure, Chronic / ethnology
  • Kidney Function Tests
  • Male
  • Middle Aged
  • Organophosphonates / adverse effects*
  • Prevalence
  • Tenofovir
  • United Kingdom / epidemiology


  • Anti-HIV Agents
  • Organophosphonates
  • Indinavir
  • Tenofovir
  • Adenine