Despite antiretroviral drugs with better renal profiles, the proportion of patients living with HIV who have advanced chronic kidney disease (CKD) increased fourfold to almost 2% over a decade, as revealed in a prospective cohort study published in HIV Medicine.
A multidisciplinary approach could be useful to anticipate drug-drug interactions and toxicities and to reduce death and hospitalization, the study authors conclude.
In a cohort study of the prevalence of advanced CKD in people living with HIV, researchers assessed CKD progression under individualized multidisciplinary clinical management for 48 weeks, said corresponding author Anna Bonjoch, MD, PhD, Department of HIV, Lluita Contra la Sida Foundation, Germans Trias i Pujol University Hospital, Barcelona, Spain. The clinical management included a critical review of treatment with continuous monitoring of the participants' progress and regular multidisciplinary meetings (with a nurse, nephrologist, HIV specialist, and nutritionist) to discuss cases and to design specific interventions.
Of 3090 individuals living with HIV who were attending the author's clinic in Barcelona, Spain, between June 2019 and June 2020, 55 people had advanced CKD, as determined on the basis of Kidney Disease Improving Global Outcomes (KDIGO) organization criteria (1.8% of the cohort; 95% CI, 1.31 – 2.25). All were White patients, and most were men (83.6%; median age, 58 years).
