HIV and Increased Risk of Need for Dialysis Interview with:
Magnus G. Rasch MD
Faculty of Health Sciences, University of Copenhagen
1455 København K, Denmark
Department of Infectious Diseases
Copenhagen University Hospital, Rigshospitalet, Denmark What are the main findings of the study?

Dr. Rasch: In the study “Increased risk of dialysis and end-stage renal disease among HIV patients in Denmark compared with the background population” we found that the risk of acute renal replacement therapy (aRRT) and the risk of chronic renal replacement therapy (cRRT) was increased substantially in HIV patients compared with the background population.

The risk of aRRT was highest the first year after HIV diagnosis.

Factors associated with increased risk of aRRT were intravenous drug use, hypertension and an AIDS-defining illness. Risk factors for cRRT were hypertension and baseline estimated glomerular filtration rate. What should patients and clinicians take away from this report?

Dr. Rasch:  We found no association between tenofovir, atazanavir or the combination atazanavir/tenofovir and risk of aRRT or cRRT. This was quite surprising since many previous studies have described renal adverse events when using HAART regimens containing on of the two drugs or a combination of them.

It is not surprising that HIV-patients have increased risk of acute and chronic renal complications and thus clinicians should still be careful to monitor renal function in these patients. It seems however that both tenofovir and atazanavir don’t increase the risk of dialysis compared to other drugs. To our knowledge this is the only study to evaluate specific drugs and their impact on the risk of dialysis in HIV-patients on a larger scale. What further research do you suggest as a result of this report?

Dr. Rasch: We suggest that more research should be done on this area since it has great implication on the handling of patients in everyday clinical practice.


Increased risk of dialysis and end-stage renal disease among HIV patients in Denmark compared with the background population

Nephrol Dial Transplant.

Rasch MG, Helleberg M, Feldt-Rasmussen B, Kronborg G, Larsen CS, Pedersen C, Pedersen G, Gerstoft J, Obel N.

Faculty of Health Sciences, University of Copenhagen, 1455 København K, Denmark.

2013 Aug 24. [Epub ahead of print]

Last Updated on September 11, 2013 by Marie Benz MD FAAD