Risk of End-Stage Renal Disease in HIV-Positive Potential Live Kidney Donors

被引：28

作者：

Muzaale, A. D. ^{[1
]}

Althoff, K. N. ^{[2
]}

Sperati, C. J. ^{[3
]}

Abraham, A. G. ^{[2
]}

Kucirka, L. M. ^{[1
,2
]}

Massie, A. B. ^{[1
,2
]}

Kitahata, M. M. ^{[4
]}

Horberg, M. A. ^{[5
]}

Justice, A. C. ^{[6
]}

Fischer, M. J. ^{[7
]}

Silverberg, M. J. ^{[8
]}

Butt, A. A. ^{[9
,10
,11
]}

Boswell, S. L. ^{[12
]}

Rachlis, A. R. ^{[13
]}

Mayor, A. M. ^{[14
]}

Gill, M. J. ^{[15
,16
]}

Eron, J. J. ^{[16
]}

Napravnik, S. ^{[16
]}

Drozd, D. R. ^{[17
]}

Martin, J. N. ^{[18
]}

Bosch, R. J. ^{[19
]}

Durand, C. M. ^{[3
]}

Locke, J. E. ^{[20
]}

Moore, R. D. ^{[3
]}

Lucas, G. M. ^{[3
]}

Segev, D. L. ^{[1
,2
]}

机构：

[1] Johns Hopkins Univ, Sch Med, Dept Surg, Baltimore, MD 21205 USA

[2] Johns Hopkins Sch Publ Hlth, Dept Epidemiol, Baltimore, MD 21205 USA

[3] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA

[4] Univ Washington, Ctr AIDS Res, Seattle, WA 98195 USA

[5] Mid Atlantic Permanente Inst, Rockville, MD USA

[6] Vet Affairs Connecticut Healthcare Syst, West Haven, CT USA

[7] Jesse Brown VA Med Ctr & Hines VA Hosp, Chicago, IL USA

[8] Kaiser Permanente Div Res, Oakland, CA USA

[9] Hamad Med Corp, Hamad Healthcare Qual Inst, Doha, Qatar

[10] Weill Cornell Med Coll, Doha, Qatar

[11] Weill Cornell Med Coll, New York, NY USA

[12] Fenway Hlth HIV Cohort, Boston, MA USA

[13] Sunnybrook Hlth Sci Ctr, Infect Dis Div, Toronto, ON, Canada

[14] Univ Cent Caribe, Bayamon, PR USA

[15] Sheldon M Chumir Hlth Ctr, Southern Alberta HIV Clin, Calgary, AB, Canada

[16] Univ N Carolina, HIV Clin Cohort, Chapel Hill, NC USA

[17] Polyclin Madison Ctr, Seattle, WA USA

[18] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA

[19] Harvard TH Chan Sch Publ Hlth, Dept Biostat, Boston, MA USA

[20] Univ Alabama Birmingham, Dept Surg, Birmingham, AL 35294 USA

来源：

AMERICAN JOURNAL OF TRANSPLANTATION | 2017年 / 17卷 / 07期

基金：

美国国家卫生研究院; 美国医疗保健研究与质量局; 加拿大健康研究院;

关键词：

BODY-MASS INDEX; INFECTED PATIENTS; AFRICAN-AMERICAN; VARIANTS; INDIVIDUALS; COHORT; ADULTS; ESRD; RACE;

D O I：

10.1111/ajt.14235

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

New federal regulations allow HIV-positive individuals to be live kidney donors; however, potential candidacy for donation is poorly understood given the increased risk of end-stage renal disease (ESRD) associated with HIV infection. To better understand this risk, we compared the incidence of ESRD among 41 968 HIV-positive participants of North America AIDS Cohort Collaboration on Research and Design followed for a median of 5 years with the incidence of ESRD among comparable HIV-negative participants of National Health and Nutrition Examination III followed for a median of 14 years. We used risk associations from multivariable Cox proportional hazards regression to derive cumulative incidence estimates for selected HIV-positive scenarios (no history of diabetes, hypertension, AIDS, or hepatitis C virus coinfection) and compared these estimates with those from similarly selected HIV-negative scenarios. For 40-year-old HIV-positive individuals with health characteristics that were similar to those of age-matched kidney donors, viral load < 400 copies/mL, and CD4(+) count >= 500 cells/lL, the 9-year cumulative incidence of ESRD was higher than that of their HIV-negative peers, yet still low: 2.5 versus 1.1 per 10 000 among white women, 3.0 versus 1.3 per 10 000 among white men, 13.2 versus 3.6 per 10 000 among black women, and 15.8 versus 4.4 per 10 000 among black men. HIV-positive individuals with no comorbidities and well-controlled disease may be considered low-risk kidney donor candidates.

引用

页码：1823 / 1832

页数：10

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