Prevalence and Risk Factors Associated to Chronic Kidney Disease in HIV-Infected Patients on HAART and Undetectable Viral Load in Brazil 英文参考文献.docVIP

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Prevalence and Risk Factors Associated to Chronic Kidney Disease in HIV-Infected Patients on HAART and Undetectable Viral Load in Brazil 英文参考文献.doc

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Prevalence and Risk Factors Associated to Chronic Kidney Disease in HIV-Infected Patients on HAART and Undetectable Viral Load in Brazil 英文参考文献

PrevalenceandRiskFactorsAssociatedtoChronic KidneyDiseaseinHIV-InfectedPatientsonHAARTand UndetectableViralLoadinBrazil Andre′iaM.Menezes1,JorgeTorellyJr1,Lu′ciaReal1,Mo?nicaBay2,JuliaPoeta1,EduardoSprinz1,2* 1FaculdadedeMedicina,UniversidadeFederaldoRioGrandedoSul,PortoAlegre,RioGrandedoSul,Brazil,2HospitaldeCl?′nicasdePortoAlegre,PortoAlegre,Rio GrandedoSul,Brazil Abstract Background: To determine the prevalence and associated factors with chronic kidney disease (CKD) in a cohort of HIV- positiveindividualswithundetectableviralloadonHAART. Methods:FromMarch,2009toSeptember2009,213individualsbetween18-70years,periodonHAART$12months,viral load , 50 copies/mm3, and CD4 $ 200 cells/mm3, were consecutively enrolled at the outpatient clinic of Hospital de Cl?′nicas,PortoAlegre,Brazil.Exclusioncriteriawereobesity,malnourishment,amputee,paraplegic,previoushistoryofrenal disease,pregnancyandhepaticinsufficiency.Renalfunctionwasdeterminedbyestimatedglomerularfiltrationrate(eGFR) assessedbythemodificationofdietinrenaldisease.CKDwasdefinedasaneGFRlessorequalthan60ml/min/1.73m2 ,for aperiodofatleast3months.PoissonregressionwasusedtodeterminefactorsassociatedwithCKD. Results:CKDwasdiagnosedin8.4%ofthepopulation,andafteradjustment,theriskfactorswerehypertension(RR=3.88, 95%CI,1.84-8.16),timeonHAART(RR=1.15,95%CI,1.03–1.27)andtenofovirexposure(RR=2.25,95%CI,1.04–4.95).Higher weight(RR=,0.8895%CI,0.82–0.96)wasassociatedtonormalfunction. Conclusions:CKDwasacommonfindinginthiscohortofpatientsandwasrelatedtohypertension,timeonHAARTand tenofovirexposure.Wesuggestamorefrequentmonitoringofrenalfunction,especiallyforthosewithriskfactorstoearly identifyrenalimpairment. Citation:MenezesAM,TorellyJJr,RealL,BayM,PoetaJ,etal.(2011)PrevalenceandRiskFactorsAssociatedtoChronicKidneyDiseaseinHIV-InfectedPatients onHAARTandUndetectableViralLoadinBrazil.PLoSONE6(10):e26042.doi:10.1371/journal.pone.0026042 Editor:EsperGeorgesKallas,UniversityofSaoPaulo,Brazil ReceivedJune28,2011;AcceptedSeptember1