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PLoS Med. 2015 Mar 31;12(3):e1001809. doi: 10.1371/journal.pmed.1001809. eCollection 2015 Mar.

Development and validation of a risk score for chronic kidney disease in HIV infection using prospective cohort data from the D:A:D study.

Collaborators (2707)

Lundgren J, Powderly B, Shortman N, Moecklinghoff C, Reilly G, Franquet X, Sabin C, Phillips A, Kirk O, Reiss P, Weber R, Pradier C, Law M, d'Arminio Monforte A, Dabis F, El-Sadr W, De Wit S, Powderly B, Shortman N, Moecklinghoff C, Reilly G, Franquet X, Ryom L, Sabin C, Kamara D, Smith C, Phillips A, Mocroft A, Tverland J, Mansfeld M, Nielsen J, Raben D, Lundgren J, Salbøl Brandt R, Rickenbach M, Fanti I, Krum E, Hillebregt M, Geffard S, Sundström A, Delforge M, Fontas E, Torres F, McManus H, Wright S, Kjær J, Sjøl A, Meidahl P, Helweg-Larsen J, Schmidt Iversen J, Ryom L, Mocroft A, Kirk O, Reiss P, Ross M, Fux C, Morlat P, Moranne O, Kesselring A, Kamara D, Smith C, Lundgren J, Smith C, Ryom L, Phillips A, Weber R, Morlat P, Pradier C, Reiss P, Friis-Møller N, Kowalska J, Lundgren J, Sabin C, Law M, d'Arminio Monforte A, Dabis F, Bruyand M, Reiss P, Smith C, Kamara D, Bower M, Fätkenheuer G, Donald A, Grulich A, Ryom L, Lundgren J, Prins J, Kuijpers T, Scherpbier H, van der Meer J, Wit F, Godfried M, Reiss P, van der Poll T, Nellen F, Geerlings S, van Vugt M, Pajkrt D, Bos J, Wiersinga W, van der Valk M, Goorhuis A, Hovius J, van Eden J, Henderiks A, van Hes A, Mutschelknauss M, Nobel H, Pijnappel F, Westerman A, Jurriaans S, Back N, Zaaijer H, Berkhout B, Cornelissen M, Schinkel C, Thomas X, De Ruyter Ziekenhuis A, van den Berge M, Stegeman A, Baas S, Hage de Looff L, Versteeg D, Pronk M, Ammerlaan H, Korsten-Vorstermans E, de Munnik E, Jansz A, Tjhie J, Wegdam M, Deiman B, Scharnhorst V, van der Plas A, Weijsenfeld A, van der Ende M, de Vries-Sluijs T, van Gorp E, Schurink C, Nouwen J, Verbon A, Rijnders B, Bax H, Hassing R, van der Feltz M, Bassant N, van Beek J, Vriesde M, van Zonneveld L, de Oude-Lubbers A, van den Berg-Cameron H, Bruinsma-Broekman F, de Groot J, de Zeeuw-de Man M, Broekhoven-Kruijne M, Schutten M, Osterhaus A, Boucher C, Driessen G, van Rossum A, van der Knaap L, Visser E, Branger J, Duijf-van de Ven CJ, Schippers EF, van Nieuwkoop C, Brimicombe R, van IJperen JM, van der Hut G, Franck P, van Eeden A, Brokking W, Groot M, Damen M, Kwa I, Groeneveld P, Bouwhuis J, van den Berg J, van Hulzen A, van der Bliek G, Bor P, Bloembergen P, Wolfhagen M, Ruijs G, Gasthuis K, van Lelyveld S, Soetekouw R, Hulshoff N, van der Prijt L, Schoemaker M, Bermon N, van der Reijden W, Jansen R, Herpers B, Veenendaal D, Kroon FP, Arend S, de Boer M, Bauer M, Jolink H, Vollaard A, Dorama W, Moons C, Claas EC, Kroes A, den Hollander J, Pogany K, Kastelijns M, Smit J, Smit E, Bezemer M, van Niekerk T, Pontesilli O, Lowe S, Oude Lashof A, Posthouwer D, Ackens R, Schippers J, Vergoossen R, Weijenberg Maes B, Savelkoul P, Loo I, Weijer S, El Moussaoui R, Heitmuller M, Heitmuller M, Kortmann W, van Twillert G, Cohen Stuart J, Diederen B, Pronk D, van Truijen-Oud F, van der Reijden W, Jansen R, Leyten E, Gelinck L, van Hartingsveld A, Meerkerk C, Wildenbeest G, Mutsaers J, Jansen C, van Vonderen M, van Houte D, Dijkstra K, Faber S, Weel J, Kootstra G, Delsing C, van der Burg-van de Plas M, Heins H, Lucas E, Brinkman K, Frissen P, Blok W, Schouten W, Bosma A, Brouwer C, Geerders G, Hoeksema K, Kleene M, van der Meché I, Toonen A, Wijnands S, van Ogtrop M, Jansen R, Koopmans P, Keuter M, van der Ven AJ, ter Hofstede H, Dofferhoff A, van Crevel R, Albers M, Bosch M, Grintjes-Huisman K, Zomer B, Stelma F, Burger D, Richter C, van der Berg J, Gisolf E, ter Beest G, van Bentum P, Langebeek N, Tiemessen R, Swanink C, Veenstra J, Lettinga K, Spelbrink M, Sulman H, Spelbrink M, Witte E, Damen M, Peerbooms P, Mulder J, Vrouenraets S, Lauw F, van Broekhuizen M, Paap H, Vlasblom D, Oudmaijer Sanders E, Smits P, Rosingh A, Verhagen D, Geilings J, van Kasteren M, Brouwer A, de Kruijf-van de Wiel BA, Kuipers M, Santegoets R, van der Ven B, Marcelis J, Buiting A, Kabel P, Bierman W, Sprenger H, Scholvinck E, van Assen S, Wilting K, Stienstra Y, de Groot-de Jonge H, van der Meulen P, de Weerd D, Niesters H, Riezebos-Brilman A, van Leer-Buter C, Hoepelman A, Schneider M, Mudrikova T, Ellerbroek P, Oosterheert J, Arends J, Barth R, Wassenberg M, van Elst-Laurijssen D, Laan L, van Oers-Hazelzet E, Patist J, Vervoort S, Nieuwenhuis H, Frauenfelder R, Schuurman R, Verduyn-Lunel F, Wensing A, Peters E, van Agtmael M, Perenboom R, Bomers M, de Vocht J, Elsenburg L, Pettersson A, Vandenbroucke-Grauls C, Ang C, Geelen S, Wolfs T, Bont L, Nauta N, Reiss P, Bezemer D, Gras L, van Sighem A, Smit C, Zaheri S, Hillebregt M, Kimmel V, Tong Y, Lascaris B, van den Boogaard R, Hoekstra P, de Lang A, Berkhout M, Grivell S, Jansen A, de Groot L, van den Akker M, Bergsma D, Lodewijk C, Meijering R, Peeck B, Raethke M, Ree C, Regtop R, Ruijs Y, Schoorl M, Tuijn E, Veenenberg L, Woudstra T, Bakker Y, de Jong A, Broekhoven M, Claessen E, Rademaker M, Munjishvili L, Kruijne E, Tuk B, Dabis F, Bonnet F, Dabis F, Dupon M, Chêne G, Breilh D, Fleury H, Malvy D, Mercié P, Pellegrin I, Morlat P, Neau D, Pellegrin J, Bouchet S, Gaborieau V, Lacoste D, Tchamgoué S, Thiébaut R, Chêne G, Dabis F, Thiébaut R, Bruyand M, Lawson-Ayayi S, Wittkop L, Morlat P, Bonnet F, Bernard N, Hessamfar M, Lacoste D, Vandenhende M, Dupon M, Dauchy F, Dutronc H, Longy-Boursier M, Mercié P, Duffau P, Schmeltz J, Malvy D, Pistone T, Receveur M, Neau D, Cazanave C, Ochoa A, Vareil MO, Pellegrin J, Viallard JF, Greib C, Lazaro E, Fleury H, Lafon M, Reigadas S, Trimoulet P, Breilh D, Molimard M, Bouchet S, Titier K, Moreau J, Pellegrin I, Haramburu F, Miremont-Salamé G, Dupont A, Gerard Y, André K, Bonnal F, Farbos S, Gemain M, Ceccaldi J, Tchamgoué S, De Witte S, Courtault C, Monlun E, Gaborieau V, Lataste P, Meraud JP, Chossat I, Blaizeau M, Bruyand M, Conte V, Decoin M, Delaune J, Delveaux S, Diarra F, D'Ivernois C, Frosch A, Geffard S, Hannapier C, Lawson-Ayayi S, Lenaud E, Leleux O, Le Marec F, Leray J, Louis I, Palmer G, Pougetoux A, Sicard X, Uwamaliya-Nziyumvira D, Law M, Petoumenos K, McManus H, Wright S, Bendall C, Moore R, Edwards S, Hoy J, Watson K, Roth N, Nicholson J, Bloch M, Franic T, Baker D, Vale R, Carr A, Cooper D, Chuah J, Ngieng M, Nolan D, Skett J, Calvo G, Torres F, Mateu S, Domingo P, Sambeat M, Gatell J, Del Cacho E, Cadafalch J, Fuster M, Codina C, Sirera G, Vaqué A, De Wit S, Clumeck N, Delforge M, Necsoi C, Clumeck N, De Wit S, Gennotte A, Gerard M, Kabeya K, Konopnicki D, Libois A, Martin C, Payen M, Semaille P, Van Laethem Y, Neaton J, Bartsch G, El-Sadr W, Krum E, Thompson G, Wentworth D, Luskin-Hawk R, Telzak E, El-Sadr W, Abrams D, Cohn D, Markowitz N, Arduino R, Mushatt D, Friedland G, Perez G, Tedaldi E, Fisher E, Gordin F, Crane L, Sampson J, Baxter J, Lundgren J, Kirk O, Mocroft A, Cozzi-Lepri A, Grint D, Podlekareva D, Kjær J, Peters L, Reekie J, Kowalska J, Tverland J, Fischer A, Nielsen J, Losso M, Elias C, Vetter N, Zangerle R, Karpov I, Vassilenko A, Mitsura V, Suetnov O, Clumeck N, De Wit S, Delforge M, Colebunders R, Vandekerckhove L, Hadziosmanovic V, Kostov K, Begovac J, Machala L, Jilich D, Sedlacek D, Nielsen J, Kronborg G, Benfield T, Larsen M, Gerstoft J, Katzenstein T, Hansen E, Skinhøj P, Pedersen C, Ostergaard L, Zilmer K, Smidt J, Ristola M, Katlama C, Viard JP, Girard PM, Livrozet JM, Vanhems P, Pradier C, Dabis F, Neau D, Rockstroh J, Schmidt R, van Lunzen J, Degen O, Stellbrink H, Staszewski S, Bickel M, Fätkenheuer G, Kosmidis J, Gargalianos P, Xylomenos G, Perdios J, Panos G, Filandras A, Karabatsaki E, Sambatakou H, Banhegyi D, Mulcahy F, Yust I, Turner D, Burke M, Pollack S, Hassoun G, Maayan S, Vella S, Esposito R, Mazeu I, Mussini C, Arici C, Pristera R, Mazzotta F, Gabbuti A, Vullo V, Lichtner M, Chirianni A, Montesarchio E, Gargiulo M, Antonucci G, Testa A, Narciso P, Vlassi C, Zaccarelli M, Lazzarin A, Castagna A, Gianotti N, Galli M, Ridolfo A, d'Arminio Monforte A, Rozentale B, Zeltina I, Chaplinskas S, Hemmer R, Staub T, Reiss P, Ormaasen V, Maeland A, Bruun J, Knysz B, Gasiorowski J, Horban A, Bakowska E, Grzeszczuk A, Flisiak R, Boron-Kaczmarska A, Pynka M, Parczewski M, Beniowski M, Mularska E, Trocha H, Jablonowska E, Malolepsza E, Wojcik K, Antunes F, Doroana M, Caldeira L, Mansinho K, Maltez F, Duiculescu D, Rakhmanova A, Zakharova N, Petersburg S, Buzunova S, Jevtovic D, Mokráš M, Staneková D, Tomazic J, González-Lahoz J, Soriano V, Labarga P, Medrano J, Moreno S, Rodriguez J, Clotet B, Jou A, Paredes R, Tural C, Puig J, Bravo I, Gatell J, Miró J, Domingo P, Gutierrez M, Mateo G, Sambeat M, Karlsson A, Flamholc L, Ledergerber B, Weber R, Francioli P, Cavassini M, Hirschel B, Boffi E, Furrer H, Battegay M, Elzi L, Kravchenko E, Chentsova N, Frolov V, Kutsyna G, Servitskiy S, Krasnov M, Barton S, Johnson A, Mercey D, Phillips A, Johnson M, Mocroft A, Murphy M, Weber J, Scullard G, Fisher M, Leen C, Morfeldt L, Thulin G, Sundström A, Åkerlund B, Koppel K, Karlsson A, Flamholc L, Håkangård C, Moroni M, Angarano G, Antinori A, Armignacco O, d'Arminio Monforte A, Castelli F, Cauda R, Di Perri G, Galli M, Iardino R, Ippolito G, Lazzarin A, Perno C, von Schloesser F, Viale P, d'Arminio Monforte A, Antinori A, Castagna A, Ceccherini-Silberstein F, Cozzi-Lepri A, Girardi E, Lo Caputo S, Mussini C, Puoti M, Andreoni M, Ammassari A, Antinori A, d'Arminio Monforte A, Balotta C, Bonfanti P, Bonora S, Borderi M, Capobianchi R, Castagna A, Ceccherini-Silberstein F, Cingolani A, Cinque P, Cozzi-Lepri A, De Luca A, Di Biagio A, Girardi E, Gianotti N, Gori A, Guaraldi G, Lapadula G, Lichtner M, Lo Caputo S, Madeddu G, Maggiolo F, Marchetti G, Marcotullio S, Monno L, Mussini C, Puoti M, Quiros Roldan E, Rusconi S, Cozzi-Lepri A, Cicconi P, Fanti I, Formenti T, Galli L, Lorenzini P, Giacometti A, Costantini A, Angarano G, Monno L, Santoro C, Maggiolo F, Suardi C, Viale P, Vanino E, Verucchi G, Castelli F, Quiros Roldan E, Minardi C, Quirino T, Abeli C, Manconi P, Piano P, Vecchiet J, Falasca K, Sighinolfi L, Segala D, Mazzotta F, Lo Caputo S, Cassola G, Viscoli G, Alessandrini A, Piscopo R, Mazzarello G, Mastroianni C, Belvisi V, Bonfanti P, Caramma I, Castelli A, Galli M, Lazzarin A, Rizzardini G, Puoti M, d'Arminio Monforte A, Ridolfo A, Piolini R, Castagna A, Salpietro S, Carenzi L, Moioli M, Cicconi P, Marchetti G, Mussini C, Puzzolante C, Gori A, Lapadula G, Abrescia N, Chirianni A, Guida M, Onofrio M, Baldelli F, Francisci D, Parruti G, Ursini T, Magnani G, Ursitti M, Cauda R, Andreoni M, Antinori A, Vullo V, Cingolani A, d'Avino A, Ammassari A, Gallo L, Nicastri E, Acinapura R, Capozzi M, Libertone R, Tebano G, Cattelan A, Mura M, Madeddu G, Caramello P, Di Perri G, Orofino G, Bonora S, Sciandra M, Pellizzer G, Manfrin V, Pradier C, Fontas E, Dollet K, Caissotti C, Dellamonica P, Roger P, Bernard E, Cua E, De Salvador-Guillouet F, Durant J, Ferrando S, Dunais B, Mondain-Miton V, Perbost I, Prouvost-Keller B, Pugliese P, Naqvi A, Pillet S, Risso K, Aubert V, Barth J, Battegay M, Bernasconi E, Böni J, Bucher H, Burton-Jeangros C, Calmy A, Cavassini M, Egger M, Elzi L, Fehr J, Fellay J, Furrer H, Fux C, Gorgievski M, Günthard H, Haerry D, Hasse B, Hirsch H, Hösli I, Kahlert C, Kaiser L, Keiser O, Klimkait T, Kovari H, Ledergerber B, Martinetti G, Martinez de Tejada B, Metzner K, Müller N, Nadal D, Pantaleo G, Rauch A, Regenass A, Rickenbach M, Rudin C, Schmid P, Schultze D, Schöni-Affolter F, Schüpbach J, Speck R, Taffé P, Tarr P, Telenti A, Trkola A, Vernazza P, Weber R, Yerly S, Bhagani S, Burns F, Byrne P, Carroll A, Cropley I, Cuthbertson Z, Drinkwater T, Edwards S, Fernandez T, Garusu E, Gonzales A, Grover D, Hutchinson S, Killingley B, Murphy G, Ivens D, Johnson M, Kinloch de Loes S, Lipman M, Madge S, Marshall N, Montgomery H, Shah R, Swaden L, Tyrer M, Youle M, Webster D, Wright A, Chaloner C, Miah M, Tsintas R, Burch L, Cambiano V, Lampe F, Nakagawa F, O'Connor J, Phillips A, Smith C, Speakman A, Connell M, Clewley G, Martin S, Thomas M, Aagaard B, Aragon E, Arnaiz J, Borup L, Clotet B, Dragsted U, Fau A, Gey D, Grarup J, Hengge U, Herrero P, Jansson P, Jensen B, Jensen K, Juncher H, Lopez P, Lundgren J, Matthews C, Mollerup D, Pearson M, Phillips A, Reilev S, Tillmann K, Varea S, Angus B, Babiker A, Cordwell B, Darbyshire J, Dodds W, Fleck S, Horton J, Hudson F, Moraes Y, Pacciarini F, Palfreeman A, Paton N, Smith N, van Hooff F, Bebchuk J, Collins G, Denning E, DuChene A, Fosdick L, Harrison M, Herman-Lamin K, Krum E, Larson G, Neaton J, Nelson R, Quan K, Quan S, Schultz T, Thompson G, Wentworth D, Wyman N, Carey C, Chan F, Cooper D, Cordwell B, Courtney-Rodgers D, Drummond F, Emery S, Harrod M, Jacoby S, Kearney L, Law M, Lin E, Pett S, Robson R, Seneviratne N, Stewart M, Watts E, Finley E, Gordin F, Sánchez A, Standridge B, Vjecha M, Belloso W, Davey R, Duprez D, Gatell J, Hoy J, Lifson A, Pederson C, Perez G, Price R, Prineas R, Rhame F, Sampson J, Worley J, Modlin J, Beral V, Chaisson R, Fleming T, Hill C, Kim K, Murray B, Pick B, Seligmann M, Weller I, Cahill K, Fox L, Luzar M, Martinez A, McNay L, Pierson J, Tierney J, Vogel S, Costas V, Eckstrand J, Brown S, Abusamra L, Angel E, Aquilia S, Belloso W, Benetucci J, Bittar V, Bogdanowicz E, Cahn P, Casiro A, Contarelli J, Corral J, Daciuk L, David D, Dobrzanski W, Duran A, Ebenrstejin J, Ferrari I, Fridman D, Galache V, Guaragna G, Ivalo S, Krolewiecki A, Lanusse I, Laplume H, Lasala M, Lattes R, Lazovski J, Lopardo G, Losso M, Lourtau L, Lupo S, Maranzana A, Marson C, Massera L, Moscatello G, Olivia S, Otegui I, Palacios L, Parlante A, Salomon H, Sanchez M, Somenzini C, Suarez C, Tocci M, Toibaro J, Zala C, Agrawal S, Ambrose P, Anderson C, Anderson J, Baker D, Beileiter K, Blavius K, Bloch M, Boyle M, Bradford D, Britton P, Brown P, Busic T, Cain A, Carrall L, Carson S, Chenoweth I, Chuah J, Clark F, Clemons J, Clezy K, Cooper D, Cortissos P, Cunningham N, Curry M, Daly L, D'Arcy-Evans C, Del Rosario R, Dinning S, Dobson P, Donohue W, Doong N, Downs C, Edwards E, Edwards S, Egan C, Ferguson W, Finlayson R, Forsdyke C, Foy L, Franic T, Frater A, French M, Gleeson D, Gold J, Habel P, Haig K, Hardy S, Holland R, Hoy J, Hudson J, Hutchison R, Hyland N, James R, Johnston C, Kelly M, King M, Kunkel K, Lau H, Leamy J, Lester D, Leung J, Lohmeyer A, Lowe K, MacRae K, Magness C, Martinez O, Maruszak H, Medland N, Miller S, Murray J, Negus P, Newman R, Ngieng M, Nowlan C, Oddy J, Orford N, Orth D, Patching J, Plummer M, Price S, Primrose R, Prone I, Ree H, Remington C, Richardson R, Robinson S, Rogers G, Roney J, Roth N, Russell D, Ryan S, Sarangapany J, Schmidt T, Schneider K, Shields C, Silberberg C, Shaw D, Skett J, Smith D, Meng Soo T, Sowden D, Street A, Kiem Tee B, Thomson J, Topaz S, Vale R, Villella C, Walker A, Watson A, Wendt N, Williams L, Youds D, Aichelburg A, Cichon P, Gemeinhart B, Rieger A, Schmied B, Touzeau-Romer V, Vetter N, Colebunders R, Clumeck N, DeRoo A, Kabeya K, O'Doherty E, de Wit S, De Salles Amorim C, Basso C, Flint S, Kallas E, Levi G, Lewi D, Pereira L Jr, da Silva M, Souza T, Toscano A, Angel J, Arsenault M, Bast M, Beckthold B, Bouchard P, Chabot I, Clarke R, Cohen J, Coté P, Ellis M, Gagne C, Gill J, Houde M, Johnston B, Jubinville N, Kato C, Lamoureux N, Larson G, Latendre- Paquette J, Lindemulder A, McNeil A, McFarland N, Montaner J, Morrisseau C, O'Neill R, Page G, Piche A, Pongracz B, Preziosi H, Puri L, Rachlis A, Ralph E, Raymond I, Rouleau D, Routy J, Sandre R, Seddon T, Shafran S, Sikora C, Smaill F, Stromberg D, Trottier S, Walmsley S, Weiss K, Williams K, Zarowny D, Baadegaard B, Bengaard Andersen Á, Boedker K, Collins P, Gerstoft J, Jensen L, Moller H, Lehm Andersen P, Loftheim I, Mathiesen L, Nielsen H, Obel N, Pedersen C, Petersen D, Pors Jensen L, Trunk Black F, Aboulker J, Aouba A, Bensalem M, Berthe H, Blanc C, Bloch M, Bornarel D, Bouchaud O, Boue F, Bouvet E, Brancon C, Breaud S, Brosseau D, Brunet A, Capitant C, Ceppi C, Chakvetadze C, Cheneau C, Chennebault J, De Truchis P, Delavalle A, Delfraissy J, Dellamonica P, Delavalle A, Dumont C, Edeb N, Fabre G, Ferrando S, Foltzer A, Foubert V, Gastaut J, Gerbe J, Girard P, Goujard C, Hoen B, Honore P, Hue H, Hynh T, Jung C, Kahi S, Katlama C, Lang J, Le Baut V, Lefebvre B, Leturque N, Lévy Y, Loison J, Maddi G, Maignan A, Majerholc C, de Boever C, Meynard J, Michelet C, Michon C, Mole M, Netzer E, Pialoux G, Poizot-Martin I, Raffi F, Ratajczak M, Ravaux I, Reynes J, Salmon-Ceron D, Sebire M, Simon A, Tegna L, Tisne-Dessus D, Tramoni C, Viard J, Vidal M, Viet-Peaucelle C, Weiss L, Zeng A, Zucman D, Adam A, Arastéh K, Behrens G, Bergmann F, Bickel M, Bittner D, Bogner J, Brockmeyer N, Darrelmann N, Deja M, Doerler M, Esser S, Faetkenheuer G, Fenske S, Gajetzki S, Gey D, Goebel F, Gorriahn D, Harrer E, Harrer T, Hartl H, Hartmann M, Heesch S, Jakob W, Jäger H, Klinker H, Kremer G, Ludwig C, Mantzsch K, Mauss S, Meurer A, Niedermeier A, Pittack N, Plettenberg A, Potthoff A, Probst M, Rittweger M, Rockstroh J, Ross B, Rotty J, Rund E, Ruzicka T, Schmidt R, Schmutz G, Schnaitmann E, Schuster D, 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Abstract

BACKGROUND:

Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice.

METHODS AND FINDINGS:

A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with ≥3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR ≤ 60 ml/min/1.73 m2. Poisson regression was used to develop a risk score, externally validated on two independent cohorts. In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1:393 chance of developing CKD in the next 5 y in the low risk group (risk score < 0, 33 events), rising to 1:47 and 1:6 in the medium (risk score 0-4, 103 events) and high risk groups (risk score ≥ 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria.

CONCLUSIONS:

Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.

PMID:
25826420
PMCID:
PMC4380415
DOI:
10.1371/journal.pmed.1001809
[Indexed for MEDLINE]
Free PMC Article

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