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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 PLoS+One
2018 ; 13
(4
): e0195443
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Chronic kidney disease in the global adult HIV-infected population: A systematic
review and meta-analysis
#MMPMID29659605
Ekrikpo UE
; Kengne AP
; Bello AK
; Effa EE
; Noubiap JJ
; Salako BL
; Rayner BL
; Remuzzi G
; Okpechi IG
PLoS One
2018[]; 13
(4
): e0195443
PMID29659605
show ga
INTRODUCTION: The widespread use of antiretroviral therapies (ART) has increased
life expectancy in HIV patients, predisposing them to chronic non-communicable
diseases including Chronic Kidney Disease (CKD). We performed a systematic review
and meta-analysis (PROSPERO registration number CRD42016036246) to determine the
global and regional prevalence of CKD in HIV patients. METHODS: We searched
PubMed, Web of Science, EBSCO and AJOL for articles published between January
1982 and May 2016. CKD was defined as estimated glomerular filtration rate (eGFR)
<60ml/min using the MDRD, Cockcroft-Gault or CKD-EPI equations. Random effects
model was used to combine prevalence estimates from across studies after variance
stabilization via Freeman-Tukey transformation. RESULT: Sixty-one eligible
articles (n = 209,078 HIV patients) in 60 countries were selected. The overall
CKD prevalence was 6.4% (95%CI 5.2-7.7%) with MDRD, 4.8% (95%CI 2.9-7.1%) with
CKD-EPI and 12.3% (95%CI 8.4-16.7%) with Cockcroft-Gault; p = 0.003 for
difference across estimators. Sub-group analysis identified differences in
prevalence by WHO region with Africa having the highest MDRD-based prevalence at
7.9% (95%CI 5.2-11.1%). Within Africa, the pooled MDRD-based prevalence was
highest in West Africa [14.6% (95%CI 9.9-20.0%)] and lowest in Southern Africa
(3.2%, 95%CI 3.0-3.4%). The heterogeneity observed could be explained by WHO
region, comorbid hypertension and diabetes mellitus, but not by gender, hepatitis
B or C coinfection, CD4 count or antiretroviral status. CONCLUSION: CKD is common
in HIV-infected people, particularly in Africa. HIV treatment programs need to
intensify screening for CKD with added need to introduce global guidelines for
CKD identification and treatment in HIV positive patients.