Journal
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
Volume 5, Issue 12, Pages 2269-2275Publisher
AMER SOC NEPHROLOGY
DOI: 10.2215/CJN.00520110
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Funding
- National Institute of Diabetes, Digestive and Kidney Diseases [5 T32 DK007569-17, K24 DK62849]
- National Kidney Foundation
- National Center on Minority Health and Health Disparities/National Institutes of Health
- Clinical Translational Science [1UL-1RR024975]
- Vanderbilt-Meharry Center for AIDS Research (National Institutes of Health) [P30 AI054999]
- National Center for Complementary and Alternative Medicine [K23 AT002508]
- Tennessee Valley VA Clinical Research Center of Excellence
- National Center for Research Resources
- National Institutes of Allergy and Infectious Diseases [K24 A1065298]
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Background and objectives: The burden of HIV-associated chronic kidney disease (CKD) is growing in the United States, partially because of increased HIV-infection rates among African Americans. We determined the prevalence, incidence, and risk of rapid estimated GFR (eGFR) decline, ESRD, and death among HIV-infected (HIV+) African-American and non-African American individuals cared for at the Comprehensive Care Center in Nashville, Tennessee, from January 1, 1998, through December 31, 2005. Design, setting, participants, & measurements: Mixed effects, competing risks, and Poisson and Cox regression models were used to assess the risk of rapid eGFR decline (defined as >= 50% decrease in baseline eGFR), CKD5/ESRD, and death. The Chronic Kidney Disease Epidemiology Collaboration equation was used to calculate eGFR. Confounders were adjusted with a propensity score that related patient characteristics to the probability of being African American. Mixed effects models compared the rate of rapid eGFR decline for HIV-infected African Americans and non-African Americans. Results: There were 2468 HIV-infected individuals in the study: 33% African American; 21% female. Among all patients, HIV-infected African Americans did not have a statistically significant increased risk for rapid eGFR decline compared with non-African Americans. However, African Americans had a significantly higher risk of ESRD and tended toward a higher risk of death. Conclusions: HIV-infected African Americans did not have a statistically significant difference in the risk of eGFR decline when compared with HIV-infected non-African Americans. The findings in this study have potential public health significance. Clin J Am Soc Nephrol 5: 2269-2275, 2010. doi: 10.2215/CJN.00520110
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