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Pediatr Nephrol. 2015 Jan;30(1):153-65. doi: 10.1007/s00467-014-2909-1. Epub 2014 Aug 24.

Predictors of resolution and persistence of renal laboratory abnormalities in pediatric HIV infection.

Collaborators (238)

Culnane M, Hawkins E, Mofenson L, Bryson YJ, Connor EM, D'Angelo L, Mintz M, O'Donnell KJ, Oxtoby M, Hale AR, Gelber RD, Gortmaker S, Lenderking W, Marrow L, Joy C, Clark C, Cunningham B, Sperling R, Scott GB, Fletcher C, Caldwell B, Donovan D, Smith E, Fresia A, Ciupak G, Eagle M, Smith DR, Palumbo P, Sleasman J, Connor J, Hughes M, Oyomopita R, Johnson G, Wiznia A, Hutton N, Kovacs A, Sawyer M, Anderson M, Rogers A, Borkowsky W, Lindsey J, Moye J, Levin M, Crain M, Britto P, Toumala R, Cervia J, Monagham E, Dominguez K, Higgins M, Seage G, Gaughan D, Gona P, Shearer W, Howland L, Storm D, Malee K, Mitchell W, Gore C, Powell E, McConnell M, Beatty N, Brogly S, Bryant J, Chernoff M, Heckman B, English D, Handelsman E, Philippe PJ, Kaiser K, Kraimer J, Millar L, Traite S, Williams P, Woods E, Worrell C, Mitchell CD, Chernoff MC, Seage GR 3rd, Purswani MU, Spiegel HM, Heckman B, Oleske JM, Andiman W, Oleske J, Bardeguez A, Dieudonne A, Bettica L, Johnson J, Pelton SI, Cooper ER, Kay L, Regan AM, Church JA, Dunaway T, Deveikis A, Batra J, Marks S, Keller MA, Redjal N, Wettgen S, Sullivan S, Hutton N, Griffith B, Joyner M, Keifer C, Watson D, Farley J, Paul ME, Jackson CD, Minglana F, Schwarzwald H, Boyer KM, Martinez J, McAuley JB, Haak M, Brady M, Koranyi K, Hunkler J, Callaway C, Scott GB, Mitchell CD, Florez C, Gamber J, Wara DW, Petru A, Tilton N, Muscat M, Petru A, Courville T, Gold K, Eng K, Spector SA, Viani RM, Caffery M, Norris K, Donnelly M, McGann K, Mathison C, Swetnam J, Belhorn T, Eddleman J, Pitkin B, Bonagura VR, Schuval S, Kaplan B, Colter C, Abrams EJ, Frere M, Calo D, Borkowsky W, Deygoo N, Minter M, Akleh S, Dobbins D, Wimbley D, D'Angelo L, Spiegel H, Melvin AJ, Mohan KM, Acker M, Phelps S, Rich KC, Hayani K, Camacho J, Andiman WA, Hurst L, de Jesus J, Schroeder D, Ferraro D, Perillo J, Kelly M, Rana S, Finke H, Yu P, Roa J, Kovacs A, Homans J, Neely M, Spencer L, Rathore MH, Mirza A, Thoma K, Mendoza A, Puga AM, Talero G, Blood J, Juliano S, Weinberg GA, Murante B, Laverty S, Gigliotti F, Lavoie SR, Smith TY, Gaur A, Knapp K, Patel N, Donohoe M, Febo IL, Lugo L, Santos R, Heyer I, Douglas SD, Rutstein RM, Vincent CA, Coburn PC, Foster J, Chen J, Conway D, Laguerre R, Stuard E, Nubel C, Hagmann S, Purswani M, Bamji M, Pathak I, Manwani S, Patel E, Luzuriaga K, Moriarty R, Stechenberg BW, Fisher DJ, Johnston AM, Toye M, Salazar JC, Fullerton K, Karas G, Foshee S, Mani CS, Murray DL, White C, Mancao MY, Estrada B, Wilcox R, Silio M, Alchediak T, Borne C, Bradford S.

Author information

1
Division of Infectious Diseases and Immunology, Department of Pediatrics, University of Miami Miller School of Medicine, Room 286, Batchelor Children's Research Institute, 1580 NW 10th Avenue, Miami, 33136, FL, USA, cmitchel@med.miami.edu.

Abstract

BACKGROUND:

Among human immunodeficiency virus (HIV)-infected youth, the role of renal disease (RD) and its management has become increasingly important as these children/adolescents mature into young adults. The identification of predictors of abnormal renal laboratory events (RLE) may be helpful in the management of their HIV infection and its associated renal complications.

METHODS:

Data collected from HIV-infected youth followed for ≥ 48 months were analyzed to identify predictors of resolution versus persistence of RLE and determine the utility of RLE to predict the onset of RD. Analysis included descriptive and inferential methods using a multivariable extended Cox proportional hazards model.

RESULTS:

Of the 1,874 at-risk children enrolled in the study, 428 (23 %) developed RLE, which persisted in 229 of these (54 %). CD4 percentages of <25 % [hazard ratio (HR) 0.63, p < 0.002) and an HIV viral load of >100,000 copies/ml (HR 0.31, p < 0.01) were associated with reduced rates of resolution, while in most cases exposure to highly active antiretroviral therapy (HAART)/nephrotoxic HAART prior to or subsequent to RLE were not. Persistence of RLE was 88 % sensitive for identifying new RD. Negative predictive values for RD were >95 % for both the at-risk cohort and those with RLE.

CONCLUSIONS:

Advanced HIV disease predicted persistence of RLE in HIV-infected youth. Persistent RLE were useful for identifying RD.

PMID:
25149850
PMCID:
PMC4301405
DOI:
10.1007/s00467-014-2909-1
[Indexed for MEDLINE]
Free PMC Article

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