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The impact of immunosuppression on chronic kidney disease in people living with HIV; the D:A:D study.

Ryom, L; Lundgren, JD; Reiss, P; Ross, M; Kirk, O; Fux, CA; Morlat, P; ... D:A:D Study Group, ; + view all (2020) The impact of immunosuppression on chronic kidney disease in people living with HIV; the D:A:D study. Journal of Infectious Diseases 10.1093/infdis/jiaa396. (In press).

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Abstract

BACKGROUND: Relations between different measures of HIV-related immunosuppression and chronic kidney disease (CKD) remain unknown. METHODS: Immunosuppression measures included baseline, current, time-lagged and nadir CD4, years and percentage of follow-up (%FU) with CD4<200, and CD4 recovery. CKD: confirmed estimated glomerular filtration rate <60mL/min/1.73m2. RESULTS: Of 33,791 persons 2,226 developed CKD. Univariably, all immunosuppression measures predicted CKD. Multivariably, the strongest predictor was %FU CD4<200 (0 vs. >25%, IRR 0.77 [0.68-0.88]) with highest effect in those at low D:A:D CKD risk (0.45 [0.24-0.80]) vs. 0.80 [0.70-0.93]). CONCLUSION: Longer immunosuppression duration most strongly predicts CKD and affects persons at low CKD risk more.

Type: Article
Title: The impact of immunosuppression on chronic kidney disease in people living with HIV; the D:A:D study.
Location: United States
DOI: 10.1093/infdis/jiaa396
Publisher version: https://doi.org/10.1093/infdis/jiaa396
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: CD4, CKD, HIV, Immunosuppression, chronic kidney disease, eGFR, renal
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10105250
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