Incidence of impaired kidney function among people with HIV: a systematic review and meta-analysis.

BMC Nephrol

School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, P.O.Box 289, 138 Yi Xue Yuan Road, Shanghai, 200032, China.

Published: March 2022

Background: In the era of combination antiretroviral therapy (ART), the incidence, manifestations and severity of kidney diseases have dramatically changed in people living with HIV (PLWH). Little is known about the incidence of impaired kidney function (IKF) measured by serum creatine-based estimated glomerular filtration rate (eGFR) in PLWH.

Methods: In this systematic review and meta-analysis, we searched PubMed, Ovid, Medline, Embase and Web of Science for studies published before May 7th, 2021, with estimates of incidence of IKF among PLWH. We independently reviewed each study for quality by using the Newcastle-Ottawa scale. The incidence and 95% confidence intervals (CIs) were calculated using random-effects model.

Results: Sixty out of 3797 identifiable studies were eligible for the meta-analysis. A total of 19 definitions of IKF were described and categorized into three types: the threshold of eGFR, an absolute or percent decrease in eGFR, and certain eGFR threshold combined with decrement in eGFR. The eGFR< 60 ml/min/1.73m was the most widely used definition or criterion for IKF, by which the pooled incidence rate of IKF was 12.50 (95%CI: 9.00-17.36) per 1000 person years (PYs). The second most-studied outcome was a > 25% decrease in eGFR, followed by eGFR< 90 ml/min/1.73m, eGFR< 30 ml/min/1.73m and a combination of eGFR threshold plus decreased eGFR. The reported incidence rates of IKF differ widely by different definitions of IKF. The highest pooled incidence was observed for those with > 25% decrease in eGFR, while the lowest was observed in those with eGFR < 30 ml/min/1.73m. Substantial heterogeneity was identified across most estimates.

Conclusion: Our study provides a comprehensive summary of eGFR-based definitions and incidence rates of IKF in PLWH, not only promoting our understanding of IKF, but also underscoring needs for a concerted action to unify definitions and outcomes of IKF and their applications in AIDS care.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8932163PMC
http://dx.doi.org/10.1186/s12882-022-02721-xDOI Listing

Publication Analysis

Top Keywords

incidence impaired
8
impaired kidney
8
kidney function
8
systematic review
8
review meta-analysis
8
decrease egfr
8
egfr egfr
8
egfr
7
incidence
5
function people
4

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!