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Clinical epidemiology of HIV-associated end-stage renal failure in the UK.

机译：在英国，HIV相关的终末期肾衰竭的临床流行病学。

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OBJECTIVE: To describe the clinical epidemiology of HIV-associated end-stage renal failure (HIV/ESRF) from 1998 to 2007 in the United Kingdom. DESIGN: Observational cohort study. SETTING: Seven leading HIV centres and affiliated renal clinics in the United Kingdom. PARTICIPANTS: A total of 21 951 patients in whom renal function was measured. MAIN OUTCOME MEASURE: Development of end-stage renal failure (ESRF) as defined by initiation of permanent renal replacement therapy (pRRT). RESULTS: Sixty-eight (0.31%) patients had HIV/ESRF, 44 (64.7%) of whom were black. The prevalence of ESRF in black patients increased over time from 0.26% in 1998-1999 to 0.92% in 2006-2007 (P for trend = 0.001). Overall 5-year survival from starting pRRT was 70.3%, and significantly better for black patients compared to those of other ethnicities (85.2 vs. 43.4%, P = 0.001). In multivariable analysis, black ethnicity was associated with a higher risk of ESRF [HR 6.93, 95% confidence interval (CI) 3.56, 13.48], whereas a higher current CD4 cell count was associated with reduced risk (HR: 0.83, 95% CI 0.76, 0.95) per 50 cells higher). No association was seen between current viral load or current highly active antiretroviral therapy (HAART) status and ESRF. On the basis of these observations, we estimate that 231 HIV-infected patients required pRRT in the United Kingdom in 2007, and an HIV prevalence of 0.51% among the United Kingdom pRRT recipients in that year. CONCLUSION: The prevalence of HIV/ESRF increased during the HAART era to reach nearly 1% in black patients, in whom favourable survival rates were observed. Earlier HIV diagnosis will be an important strategy to stem the rising trend of HIV/ESRF.
机译：目的：描述1998年至2007年英国HIV相关的终末期肾衰竭（HIV / ESRF）的临床流行病学。设计：观察性队列研究。地点：英国的7个主要的HIV中心和附属的肾脏诊所。参与者：总共21 951名患者的肾功能被测量。主要观察指标：根据开始永久性肾脏替代治疗（pRRT）定义的晚期肾衰竭（ESRF）的发生。结果：68（0.31％）患者患有HIV / ESRF，其中44（64.7％）是黑人。黑人患者中ESRF的患病率随时间从1998-1999年的0.26％上升到2006-2007年的0.92％（趋势P = 0.001）。从开始进行pRRT的总体5年生存率为70.3％，与其他种族相比，黑人患者明显更好（85.2对43.4％，P = 0.001）。在多变量分析中，黑人种族与ESRF的风险较高相关[HR 6.93，95％置信区间（CI）3.56，13.48]，而当前较高的CD4细胞计数与降低的风险相关（HR：0.83，95％CI每50个单元格高出0.76、0.95）。目前的病毒载量或目前的高活性抗逆转录病毒疗法（HAART）状态与ESRF之间没有关联。根据这些观察，我们估计2007年英国有231名HIV感染患者需要pRRT，当年英国pRRT接受者中HIV患病率为0.51％。结论：在黑人患者中，HAART期间HIV / ESRF的患病率增加，达到近1％，观察到良好的存活率。早期诊断HIV将是阻止HIV / ESRF上升趋势的重要策略。

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