Long-term clinical consequences of acute kidney injury in the HIV-infected

Andy I. Choi, Yongmei Li, Chirag Parikh, Paul A. Volberding, Michael G. Shlipak

Research output: Contribution to journalArticle

Abstract

To evaluate the long-term consequences of acute kidney injury (AKI) in human immunodeficiency virus (HIV)-infected persons, we studied 17,325 patients in a national HIV registry during their first hospitalization. We determined the association of AKI with risk for heart failure, cardiovascular events, end-stage renal disease (ESRD), and mortality beginning 90 days after discharge. Based on AKI Network criteria, 2453 had stage 1; 273 had stage 2 or 3; and 334 had dialysis-requiring AKI. Over a mean follow-up period of 5.7 years, 333 had heart failure, 673 had cardiovascular diseases (CVDs), 348 developed ESRD, and 8405 deaths occurred. In multivariable-adjusted analyses, AKI stage 1 was associated with death and ESRD, but not heart failure or other CVD. Dialysis-requiring AKI had much stronger and significant associations with increased risk for long-term ESRD, and death in addition to heart failure and cardiovascular events. When AKI was reclassified to account for recovery, stage 1 with recovery was still associated with death, but not ESRD. Thus, in this national sample of HIV-infected persons, we found the clinical repercussions of AKI appear to extend beyond the hospital setting contributing to excess cardiovascular risks, ESRD, and mortality. Additionally, AKI affected almost one of six patients with HIV who survived at least 90 days following discharge.

Original languageEnglish (US)
Pages (from-to)478-485
Number of pages8
JournalKidney International
Volume78
Issue number5
DOIs
StatePublished - Jan 1 2010

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Acute Kidney Injury
HIV
Chronic Kidney Failure
Heart Failure
Dialysis
Cardiovascular Diseases
Mortality
Registries
Hospitalization

Keywords

  • acute kidney injury
  • cardiovascular disease
  • end-stage renal disease
  • HIV
  • mortality

ASJC Scopus subject areas

  • Nephrology

Cite this

Long-term clinical consequences of acute kidney injury in the HIV-infected. / Choi, Andy I.; Li, Yongmei; Parikh, Chirag; Volberding, Paul A.; Shlipak, Michael G.

In: Kidney International, Vol. 78, No. 5, 01.01.2010, p. 478-485.

Research output: Contribution to journalArticle

Choi, Andy I. ; Li, Yongmei ; Parikh, Chirag ; Volberding, Paul A. ; Shlipak, Michael G. / Long-term clinical consequences of acute kidney injury in the HIV-infected. In: Kidney International. 2010 ; Vol. 78, No. 5. pp. 478-485.
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