The Impact of Immunosuppression on Chronic Kidney Disease in People Living With Human Immunodeficiency Virus: The D:A:D Study

Lene Ryom; Jens D Lundgren; Peter Reiss; Mike Ross; Ole Kirk; Christophe A Fux; Phillipe Morlat; Eric Fontas; Colette Smith; Stephane De Wit; Antonella D’arminio Monforte; Wafaa El Sadr; Camilla Hatleberg; Andrew Phillips; Caroline Sabin; Matthew Law; Amanda Mocroft

doi:10.1093/infdis/jiaa396

The Impact of Immunosuppression on Chronic Kidney Disease in People Living With Human Immunodeficiency Virus: The D:A:D Study

Lene Ryom, Jens D Lundgren, Peter Reiss, Mike Ross, Ole Kirk, Christophe A Fux, Phillipe Morlat, Eric Fontas, Colette Smith, Stephane De Wit, Antonella D’arminio Monforte, Wafaa El Sadr, Camilla Hatleberg, Andrew Phillips, Caroline Sabin, Matthew Law, Amanda Mocroft

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

6 Citationer (Scopus)

Abstract

Background
Relations between different measures of human immunodeficiency virus–related immunosuppression and chronic kidney disease (CKD) remain unknown.

Methods
Immunosuppression measures included baseline, current, time-lagged and nadir CD4, years and percentage of follow-up (%FU) with CD4 ≤200 cells/μL, and CD4 recovery. CKD was defined as confirmed estimated glomerular filtration rate <60 mL/minute/1.73 m2.

Results
Of 33 791 persons, 2226 developed CKD. Univariably, all immunosuppression measures predicted CKD. Multivariably, the strongest predictor was %FU CD4 ≤200 cells/μL (0 vs >25%; incidence rate ratio [IRR], 0.77 [95% confidence interval [CI], .68–.88]), with highest effect in those at low D:A:D CKD risk (IRR, 0.45 [95% CI, .24–.80]) vs 0.80 [95% CI, .70–.93]).

Conclusions
Longer immunosuppression duration most strongly predicts CKD and affects persons at low CKD risk more.

Originalsprog	Engelsk
Tidsskrift	The Journal of Infectious Diseases
Vol/bind	223
Udgave nummer	4
Sider (fra-til)	632-637
Antal sider	6
ISSN	0022-1899
DOI	https://doi.org/10.1093/infdis/jiaa396
Status	Udgivet - 24 feb. 2021

Adgang til dokumentet

10.1093/infdis/jiaa396

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7904289/pdf/jiaa396.pdfLicens: Andet

Citationsformater

Ryom, L., Lundgren, J. D., Reiss, P., Ross, M., Kirk, O., Fux, C. A., Morlat, P., Fontas, E., Smith, C., De Wit, S., D’arminio Monforte, A., El Sadr, W., Hatleberg, C., Phillips, A., Sabin, C., Law, M., & Mocroft, A. (2021). The Impact of Immunosuppression on Chronic Kidney Disease in People Living With Human Immunodeficiency Virus: The D:A:D Study. The Journal of Infectious Diseases, 223(4), 632-637. https://doi.org/10.1093/infdis/jiaa396

Ryom, L, Lundgren, JD, Reiss, P, Ross, M, Kirk, O, Fux, CA, Morlat, P, Fontas, E, Smith, C, De Wit, S, D’arminio Monforte, A, El Sadr, W, Hatleberg, C, Phillips, A, Sabin, C, Law, M & Mocroft, A 2021, 'The Impact of Immunosuppression on Chronic Kidney Disease in People Living With Human Immunodeficiency Virus: The D:A:D Study', The Journal of Infectious Diseases, bind 223, nr. 4, s. 632-637. https://doi.org/10.1093/infdis/jiaa396

@article{fb393ffa81e84e23ac733a9e9a8aab14,

title = "The Impact of Immunosuppression on Chronic Kidney Disease in People Living With Human Immunodeficiency Virus: The D:A:D Study",

abstract = "BackgroundRelations between different measures of human immunodeficiency virus–related immunosuppression and chronic kidney disease (CKD) remain unknown.MethodsImmunosuppression measures included baseline, current, time-lagged and nadir CD4, years and percentage of follow-up (%FU) with CD4 ≤200 cells/μL, and CD4 recovery. CKD was defined as confirmed estimated glomerular filtration rate <60 mL/minute/1.73 m2.ResultsOf 33 791 persons, 2226 developed CKD. Univariably, all immunosuppression measures predicted CKD. Multivariably, the strongest predictor was %FU CD4 ≤200 cells/μL (0 vs >25%; incidence rate ratio [IRR], 0.77 [95% confidence interval [CI], .68–.88]), with highest effect in those at low D:A:D CKD risk (IRR, 0.45 [95% CI, .24–.80]) vs 0.80 [95% CI, .70–.93]).ConclusionsLonger immunosuppression duration most strongly predicts CKD and affects persons at low CKD risk more.",

author = "Lene Ryom and Lundgren, {Jens D} and Peter Reiss and Mike Ross and Ole Kirk and Fux, {Christophe A} and Phillipe Morlat and Eric Fontas and Colette Smith and {De Wit}, Stephane and {D{\textquoteright}arminio Monforte}, Antonella and {El Sadr}, Wafaa and Camilla Hatleberg and Andrew Phillips and Caroline Sabin and Matthew Law and Amanda Mocroft",

year = "2021",

month = feb,

day = "24",

doi = "10.1093/infdis/jiaa396",

language = "English",

volume = "223",

pages = "632--637",

journal = "The Journal of Infectious Diseases",

issn = "0022-1899",

publisher = "Oxford University Press",

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TY - JOUR

T1 - The Impact of Immunosuppression on Chronic Kidney Disease in People Living With Human Immunodeficiency Virus

T2 - The D:A:D Study

AU - Ryom, Lene

AU - Lundgren, Jens D

AU - Reiss, Peter

AU - Ross, Mike

AU - Kirk, Ole

AU - Fux, Christophe A

AU - Morlat, Phillipe

AU - Fontas, Eric

AU - Smith, Colette

AU - De Wit, Stephane

AU - D’arminio Monforte, Antonella

AU - El Sadr, Wafaa

AU - Hatleberg, Camilla

AU - Phillips, Andrew

AU - Sabin, Caroline

AU - Law, Matthew

AU - Mocroft, Amanda

PY - 2021/2/24

Y1 - 2021/2/24

N2 - BackgroundRelations between different measures of human immunodeficiency virus–related immunosuppression and chronic kidney disease (CKD) remain unknown.MethodsImmunosuppression measures included baseline, current, time-lagged and nadir CD4, years and percentage of follow-up (%FU) with CD4 ≤200 cells/μL, and CD4 recovery. CKD was defined as confirmed estimated glomerular filtration rate <60 mL/minute/1.73 m2.ResultsOf 33 791 persons, 2226 developed CKD. Univariably, all immunosuppression measures predicted CKD. Multivariably, the strongest predictor was %FU CD4 ≤200 cells/μL (0 vs >25%; incidence rate ratio [IRR], 0.77 [95% confidence interval [CI], .68–.88]), with highest effect in those at low D:A:D CKD risk (IRR, 0.45 [95% CI, .24–.80]) vs 0.80 [95% CI, .70–.93]).ConclusionsLonger immunosuppression duration most strongly predicts CKD and affects persons at low CKD risk more.

AB - BackgroundRelations between different measures of human immunodeficiency virus–related immunosuppression and chronic kidney disease (CKD) remain unknown.MethodsImmunosuppression measures included baseline, current, time-lagged and nadir CD4, years and percentage of follow-up (%FU) with CD4 ≤200 cells/μL, and CD4 recovery. CKD was defined as confirmed estimated glomerular filtration rate <60 mL/minute/1.73 m2.ResultsOf 33 791 persons, 2226 developed CKD. Univariably, all immunosuppression measures predicted CKD. Multivariably, the strongest predictor was %FU CD4 ≤200 cells/μL (0 vs >25%; incidence rate ratio [IRR], 0.77 [95% confidence interval [CI], .68–.88]), with highest effect in those at low D:A:D CKD risk (IRR, 0.45 [95% CI, .24–.80]) vs 0.80 [95% CI, .70–.93]).ConclusionsLonger immunosuppression duration most strongly predicts CKD and affects persons at low CKD risk more.

U2 - 10.1093/infdis/jiaa396

DO - 10.1093/infdis/jiaa396

M3 - Journal article

C2 - 32640015

SN - 0022-1899

VL - 223

SP - 632

EP - 637

JO - The Journal of Infectious Diseases

JF - The Journal of Infectious Diseases

IS - 4

ER -