Chronic kidney disease in hiv-infected patients (causes, diagnosis, principles of management)

The continued growth of the population of HIV-infected individuals is caused by two processes: the high frequency of new cases of HIV infection and the effectiveness of combined antiretroviral therapy which suppresses viral replication, prevents HIV-associated diseases and leads to a better quality of life and increase in the short-term and medium-term survival of HIV-infected patients. To date, over 33 million people worldwide are infected with HIV and more than 2 million AIDS-related deaths are recorded every year. In the Russian Federation only the number of registered HIV-infected people is more than 1 million, and it increases annually by 10%. According to UNAIDS and WHO, HIV-related disease will continue to be one of the leading causes of death in the coming decades, and will play a significant role in global mortality rates. The reason for this is defined by long-term course of HIV infection with a higher risk of developing secondary and opportunistic diseases, clinically associated with a progressive decrease in immunity, as well as the defeat of various organs and systems, including kidneys. Patients with HIV are at risk for both acute kidney injury and chronic kidney disease (CKD), secondary to medication nephrotoxicity, HIV-associated nephropathy, immune complex kidney diseases, and, less commonly, kidney disease in the setting of thrombotic microangiopathy. In addition, HIV-positive patients are at increased risk of CKD associated with coinfection with viral hepatitis B and C, hypertension, diabetes. Despite the lack of randomized controlled trials presented recommendations are based on the general health guidelines and are intended to unify approaches to the detection, diagnosis, management of HIV-positive patients with CKD and create prerequisites for addressing these important health challenges.

вирус иммунодефицита человека, болезни почек, хроническая болезнь почек, клинические практические рекомендации, human immunodeficiency virus, kidney disease, chronic kidney disease, clinical practice guideline

1. Бартлетт Д., Галлант Д., Фам П. Клинические аспекты ВИЧ-инфекции. М.: Р. Валент, 2010: 497 с.

2. Волгина Г.В., Ющук Н.Д., Гаджикулиева М.М., Томилина Н.А. Нефротоксические эффекты высокоактивной антиретро- вирусной терапии. Нефрология и диализ. 2010. 12. №3: 154-164.

3. Гаджикулиева М.М. Хроническая болезнь почек у ВИЧ-инфицированных пациентов: распространеннось и клинико-морфологическая характеристика. Автореф. дисс. дмн. М. 2013: 47.

4. Гаджикулиева М., Ющук Н., Волгина Г. и соавт. Распространенность и клинико-морфологическая характеристика поражений почек при ВИЧ-инфекции. Нефрология и диализ. 2012. 14(1): 31-40.

5. Ющук Н., Гаджикулиева М., Мартынов Ю., Волгина Г. Распространенность поражения почек среди ВИЧ-инфицированных пациентов. Информационный бюллетень «Здоровье население и среда обитания». 2011. 3 (216): 12-15.

6. Ющук Н., Волгина Г., Томилина Н., Гаджикулиева М. Поражение почек антиретровирусными препаратами при ВИЧ-инфекции. Терапевт архив. 2011. 11: 66-70.

7. Ющук Н., Гаджикулиева М., Волгина Г., Томилина Н. Гломерулярные заболевания у ВИЧ-инфицированных пациентов: клиническая и морфологическая оценка. Терапевт архив. 2012. 11: 30-33.

8. Yuschuck N., Gadgikuliyeva M., Volgina G., Tomilina N. et al. Types of Glomerular Diseases in HIV-Infected Patients. Exp Clin Cardiol. 2014. 20(8): 2037-2046.

9. Aberg J.A., Gallant J.E., Ghanem K.G. et al. Infectious Diseases Society of America. Primary care guidelines for the management of persons infected with HIV: 2013 update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2014. 58(1): 1-10.

10. Alves T.P., Hulgan T., Wu P. et al. Race, kidney disease progression, and mortality risk in HIV-infected persons. Clin J Am Soc Nephrol. 2010. 5: 2269-2275.

11. Andiman W.A., Chernoff M.C., Mitchell C. et al. Incidence of persistent renal dysfunction in human immunodeficiency virus-infected children: associations with the use of antiretrovirals, and other nephrotoxic medications and risk factors. Pediatr Infect Dis J. 2009. 28: 619-625.

12. Ando M., Tsuchiya K., Nitta K. How to manage HIV-infected patients with chronic kidney disease in the HAART era. Clin Exp Nephrol. 2012. 16(3): 362-372.

13. Ando М., Yanagisawa N. Epidemiology, clinical characteristics, and management of chronic kidney disease in human immunodeficiency virus-infected patients. World J Nephrol. 2015. July 6. 4(3): 388-395.

14. Asboe D., Aitken C., Boffito M. et al. British HIV Association guidelines for the routine investigation and monitoring of adult HIV-1-infected individuals 2011. HIV Med. 2012. 13: 1-44.

15. Astor B.C., Matsushita K., Gansevoort R.T. et al. Lower estimated glomerular filtration rate and higher albuminuria are associated with mortality and end-stage renal disease. A collaborative meta-analysis of kidney disease population cohorts. Kidney Int. 2011. 79: 1331-1340.

16. Bansi L., Hughes A., Bhagani S. et al. Clinical epidemiology of HIV-associated end-stage renal failure in the UK. AIDS. 2009. 23: 2517-2521.

17. Bickel M., Anadol E., Vogel M. et al. Daily dosing of tacrolimus in patients treated with HIV-1 therapy containing a ritonavir-boosted protease inhibitor or raltegravir. J Antimicrob Chemother. 2010. 65: 999-1004.

18. Bickel M., Marben W., Betz C. et al. End-stage renal disease and dialysis in HIV-positive patients: observations from a long-term cohort study with a follow-up of 22 years. HIV Med. 2013. 14: 127-135.

19. Bonjoch A., Bayes B., Riba J. et al. Validation of estimated renal function measurements compared with the isotopic glomerular filtration rate in an HIV-infected cohort. Antiviral Res. 2010. 88: 347-354.

20. Campbell L., Dew T., Salota R. et al. Total protein, albumin and low-molecular-weight protein excretion in HIV-positive patients. BMC Nephrol. 2012. 13: 85.

21. Campbell L.J., Desai M., Hegazi A. et al. Renal impairment is associated with coronary heart disease in HIV-positive me. HIV Clin Trials. 2012. 13: 343-349.

22. Choi A., Scherzer R., Bacchetti P. et al. Cystatin C, albuminuria, and 5-year all-cause mortality in HIV-infected persons. Am J Kidney Dis. 2010. 56: 872-882.

23. Choi A.I., Li Y., Deeks S.G. et al. Association between kidney function and albuminuria with cardiovascular events in HIV-infected persons. Circulation. 2010. 121: 651-658.

24. Choi AI, Rodriguez RA, Bacchetti P, et al. Racial differences in end-stage renal disease rates in HIV infection versus diabetes. J Am Soc Nephrol. 2007. 18: 2968-2974.

25. Cohen S.D., Kimmel P.L. Immune complex renal disease and human immunodeficiency virus infection. Semin Nephrol. 2008. 28: 535-544.

26. Estrella M.M., Parekh R.S., Astor B.C. et al. Chronic kidney disease and estimates of kidney function in HIV infection: a cross-sectional study in the Multicenter AIDS Cohort Study. J Acquir Immune Defic Syndr. 2011. 57: 380-386.

27. Fernando S.K., Finkelstein F.O., Moore B.A. Weissman S. Prevalence of chronic kidney disease in an urban HIV infected population. Am J Med Sci. 2008. 335: 89-94.

28. Flandre P., Pugliese P., Cuzin L. et al. Risk factors of chronic kidney disease in HIV-infected patients. Clin J Am Soc Nephrol. 2011. 6: 1700-1707.

29. Gathogo E., Jose S., Jones R. et al. End-Stage Kidney Disease and Kidney Transplantation in HIV-Positive Patients An Observational Cohort Study. J Acquir Immune Defic Syndr. 2014. 67(2): 177-180.

30. George E., Lucas G.M., Nadkarni G.N. et al. Kidney function and the risk of cardiovascular events in HIV-1-infected patients. AIDS. 2010. 24: 387-394.

31. Gracey D.M., Fernando M., Ziegler J., White C.P., Post J.J. Importance of screening for renal disease among the human immunodeficiency virus-infected patient population. Intern Med J. 2012. 42(8): 954-955.

32. Gupta S.K., Eustace J.A., Winston J.A. et al. Guidelines for the management of chronic kidney disease in HIV-infected patients: recommendations of the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2005. 40: 1559-1585.

33. Gupta S.K., Smurzynski M., Franceschini N. et al. The effects of HIV type-1 viral suppression and non-viral factors on quantitative proteinuria in the highly active antiretroviral therapy era. Antivir Ther. 2009. 14: 543-549.

34. Hadigan C., Edwards E., Rosenberg A. et al. Microalbuminuria in HIV disease. Am J Nephrol. 2013. 37: 443-451.

35. Herlitz L.C., Mohan S., Stokes M.B. et al. Tenofovir nephrotoxicity: acute tubular necrosis with distinctive clinical, pathological, and mitochondrial abnormalities. Kidney Int. 2010. 78: 1171-1177.

36. Ibrahim F., Hamzah L., Jones R. et al. Baseline kidney function as predictor of mortality and kidney disease progression in HIV-positive patients. Am J Kidney Dis. 2012. 60: 539-547.

37. Ibrahim F., Hamzah L., Jones R. et al. Comparison of ХБП-EPI and MDRD to estimate baseline renal function in HIV-positive patients. Nephrol Dial Transplant. 2012. 27: 2291-2297.

38. Inker L.A., Wyatt C., Creamer R. et al. Performance of creatinine and cystatin C GFR estimating equations in an HIV-positive population on antiretrovirals. J Acquir Immune Defic Syndr. 2012. 61: 302-309.

39. Jotwani V., Li Y., Grunfeld C., Choi A.I., Shlipak M.G. Risk factors for ESRD in HIV-infected individuals: traditional and HIV-related factors. Am J Kidney Dis. 2012. 59: 628-635.

40. Kalayjian R.C., Lau B., Mechekano R.N. et al. Risk factors for chronic kidney disease in a large cohort of HIV-1 infected individuals initiating antiretroviral therapy in routine care. AIDS. 2012. 26: 1907-1915.

41. Kidney Disease: Improving Global Outcomes (KDIGO) Chronic Kidney Disease Work Group. KDIGO 2012 Сlinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013. 3: 1-150.

42. Lopes J.A., Melo M.J., Raimundo M. et al. Long-term risk of mortality for acute kidney injury in HIV-infected patients: a cohort analysis. BMC Nephrol. 2013. Feb. 14: 32.

43. Lucas G.M., Ross M.J., Stock P.G. et al. HIV Medicine Association of the Infectious Diseases Society of America. Сlinical practice guideline for the management of chronic kidney disease in patients infected with HIV: 2014 update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2014. 1. 59(9): 96-138.

44. May M.T., Gompels M., Delpech V. et al. Impact on life expectancy of HIV-1 positive individuals of CD4+ cell count and viral load response to antiretroviral therapy: UK cohort study. AIDS. 2014. 28: 1193-1202.

45. McCulloch M.I., Ray P.E. Kidney disease in HIV-positive children. Semin Nephrol. 2008. 28: 585-594.

46. Mocroft A., Kirk O., Reiss P. et al. Estimated glomerular filtration rate, chronic kidney disease and antiretroviral drug use in HIV-positive patients. AIDS. 2010. 24: 1667-1678.

47. Mocroft A., Ryom L., Reiss P. et al. A comparison of estimated glomerular filtration rates using Cockcroft-Gault and the Chronic Kidney Disease Epidemiology Collaboration estimating equations in HIV infection. HIV Med. 2014. 15: 144-152.

48. Okparavero A.A., Tighiouart H., Krishnasami Z. et al. Use of glomerular filtration rate estimating equations for drug dosing in HIV-positive patients. Antivir Ther. 2013. 18: 793-802.

49. Post F.A., Holt S.G. Recent developments in HIV and the kidney. Curr Opin Infect Dis. 2009. 22: 43-48.

50. Praga M., Gutiérrez Solís E., Morales E. Hepatitis C-induced renal disease in patients with AIDS: an emergent problem. Contrib Nephrol. 2012. 176: 24-34.

51. Rasch M.G., Helleberg M., Feldt-Rasmussen B. et al. Increased risk of dialysis and end-stage renal disease among HIV patients in Denmark compared with the background population. Nephrol Dial Transplant. 2014. 29: 1232-1238.

52. Ryom L., Kirk O., Lundgren J. et al. Advanced chronic kidney disease, end-stage renal disease and renal death among HIV-positive individuals in Europe. HIV Med. 2013. 14: 503-508.

53. Ryom L., Mocroft A., Kirk O. et al. Association between antiretroviral exposure and renal impairment among HIV-positive persons with normal baseline renal function: the D:A:D study. J Infect Dis. 2013. 207: 1359-1369.

54. Ryom L., Mocroft A., Kirk O. et al. Predictors of advanced chronic kidney disease and end-stage renal disease in HIV-positive persons. AIDS. 2014. 28: 187-199.

55. Ryom L., Mocroft A., Lundgren J. HIV therapies and the kidney: some good, some not so good? Curr HIV/AIDS Rep. 2012 Jun. 9(2): 111-120.

56. Scherzer R., Estrella M., Li Y. et al. Association of tenofovir exposure with kidney disease risk in HIV infection. AIDS. 2012. 26: 867-875.

57. Trullas J.C., Cofan F., Tuset M. et al. Renal transplantation in HIV-infected patients: 2010 update. Kidney Int. 2011. 79(8): 825-842.

58. Van Sighem A.I., Gras L.A., Reiss P., et al. Life expectancy of recently diagnosed asymptomatic HIV-infected patients approaches that of uninfected individuals. AIDS. 2010. 24: 1527-1535.

59. Vassalotti J.A., Winston J.A. ХБП in HIV-Infected Patients: From the New Plague to Chronic Care Management. Am J Kidney Dis. 2015. 65(6): 823-825.

60. Wyatt C.M., Hoover D.R., Shi Q. et al. Microalbuminuria is associated with all-cause and AIDS mortality in women with HIV infection. J Acquir Immune Defic Syndr. 2010. 55: 73-77.

61. Wyatt C.M., Klotman P.E., D’Agati V.D. HIV-associated nephropathy: clinical presentation, pathology, and epidemiology in the era of antiretroviral therapy. Semin Nephrol. 2008. 28: 513-22.

62. Wyatt C.M., Malvestutto C., Coca S.G. et al. The impact of hepatitis C virus coinfection on HIV-related kidney disease: a systematic review and meta-analysis. AIDS. 2008. 22: 1799-807.

63. Wyatt C.M., Morgello S., Katz-Malamed R. et al. The spectrum of kidney disease in patients with AIDS in the era of antiretroviral therapy. Kidney Int. 2009. 75: 428-434.

64. Wyatt C.M., Winston J.A., Malvestutto C.D. et al. Chronic kidney disease in HIV infection: an urban epidemic. AIDS. 2007. 21: 2101-2103.

65. Yahaya I., Uthman O.A., Uthman M.M. Interventions for HIV-associated nephropathy. Cochrane Database Syst Rev. 2013. Jan. 1: CD007183.

66. Yombi J.C., Jones R., Pozniak A., et al. Monitoring of Kidney Function in HIV-Positive Patients. HIV Medicine. 2015. 16 (8): 457-467.

67. Yombi J.C., Pozniak A., Boffito M. et al. Antiretrovirals and the kidney in current clinical practice: renal pharmacokinetics, alterations of renal function and renal toxicity. AIDS. 2014. 28: 621-632.