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Clin J Am Soc Nephrol. 2010 Dec;5(12):2269-75. doi: 10.2215/CJN.00520110. Epub 2010 Sep 28.

Race, kidney disease progression, and mortality risk in HIV-infected persons.

Author information

1
Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA. tahira.palmer@yahoo.com

Abstract

BACKGROUND AND OBJECTIVES:

The burden of HIV-associated chronic kidney disease (CKD) is growing in the United States, partially because of increased HIV-infection rates among African Americans. We determined the prevalence, incidence, and risk of rapid estimated GFR (eGFR) decline, ESRD, and death among HIV-infected (HIV+) African-American and non-African-American individuals cared for at the Comprehensive Care Center in Nashville, Tennessee, from January 1, 1998, through December 31, 2005.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS:

Mixed effects, competing risks, and Poisson and Cox regression models were used to assess the risk of rapid eGFR decline (defined as ≥50% decrease in baseline eGFR), CKD5/ESRD, and death. The Chronic Kidney Disease Epidemiology Collaboration equation was used to calculate eGFR. Confounders were adjusted with a propensity score that related patient characteristics to the probability of being African American. Mixed effects models compared the rate of rapid eGFR decline for HIV-infected African Americans and non-African Americans.

RESULTS:

There were 2468 HIV-infected individuals in the study: 33% African American; 21% female. Among all patients, HIV-infected African Americans did not have a statistically significant increased risk for rapid eGFR decline compared with non-African Americans. However, African Americans had a significantly higher risk of ESRD and tended toward a higher risk of death.

CONCLUSIONS:

HIV-infected African Americans did not have a statistically significant difference in the risk of eGFR decline when compared with HIV-infected non-African Americans. The findings in this study have potential public health significance.

PMID:
20876679
PMCID:
PMC2994089
DOI:
10.2215/CJN.00520110
[Indexed for MEDLINE]
Free PMC Article

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