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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/13430

Title: High prevalence of renal dysfunction and association with risk of death amongst HIV-infected Ghanaians
Authors: Sarfo, Fred Stephen
Keegan, Rosie
Appiah, Lambert Tetteh
Shakoor, Shaid
Phillips, Richard Odame
Norman, Betty R.
Hardy, Yasmin
Bedu-Addo, George
Longstaff, Lydia
Chadwick, David R.
Keywords: HIV
Antiretroviral therapy
Issue Date: 2013
Publisher: Journal of infection
Citation: Journal of Infection (2013) 67, 43-50
Abstract: Objectives: To determine the prevalence of HIV-associated renal dysfunction (RD), identify risk factors for RD and explore the association between baseline renal function and mortality in an HIV-infected population in Ghana. Methods: Creatinine clearance (CrCl) or estimated glomerular filtration rate (eGFR) was calculated in patients attending an HIV clinic between 2004 and 2011 using Cockcroft-Gault, MDRD and CKD-EPI formulae. Logistic regression analysis was used to identify risk factors associated with RD and KaplaneMeier/Cox proportional regression analyses to explore associations between baseline CrCl/eGFR and subsequent mortality. Results: In 3137 patients starting antiretroviral therapy (ART) the frequency (95%-CI) of RD, defined by CrCl <60 ml/min/1.73 m2 using Cockroft-Gault formula was 38.8% (37.1e40.5%). RD prevalence in a sub-population of 238 patients, including proteinuria in the definition, was 15.3% (10.3e22.1%) in ART-treated and 43.6% (34.0e53.7%) in ART-na€ıve patients. RD at baseline was associated with increasing age, low CD4 counts, advanced WHO stage and female gender. Cox proportional hazard analysis identified an increased hazard of death with decreasing CrCl, HR 1.46 (1.31e1.63) for each tertile lower than CrCl of 90 ml/min/1.73 m2. Conclusions: RD is very common in HIV-infected ART-na€ıve Ghanaians, and associated with increased risk of mortality. Screening and monitoring of RD is important in this setting, particularly as tenofovir use increases.
Description: An article published in Journal of Infection (2013) 67, 43-50; http://dx.doi.org/10.1016/j.jinf.2013.03.008
URI: http://hdl.handle.net/123456789/13430
Appears in Collections:College of Health Sciences

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