Dialysis and renal transplantation in HIV-infected patients: a European survey

J Acquir Immune Defic Syndr. 2010 Dec 15;55(5):582-9. doi: 10.1097/QAI.0b013e3181efbe59.

Abstract

Objectives: To determine prevalence and characteristics of end-stage renal diseases (ESRD) [dialysis and renal transplantation (RT)] among European HIV-infected patients.

Methods: Cross-sectional multicenter survey of EuroSIDA clinics during 2008.

Results: Prevalence of ESRD was 0.5%. Of 122 patients with ESRD 96 were on dialysis and 26 had received a RT. Median age was 47 years, 73% were males and 43% were black. Median duration of HIV infection was 11 years. Thirty-three percent had prior AIDS; 91% were receiving antiretrovirals; and 88% had undetectable viral load. Median CD4(+)T-cell count was 341 cells per cubic millimetre; 20.5% had hepatitis C coinfection. Most frequent causes of ESRD were HIV-associated nephropathy (46%) and other glomerulonephritis (28%). Hemodialysis (93%) was the most common dialysis modality; 34% of patients were on the RT waiting list. A poor HIV control was the reason for exclusion from RT waiting list in 22.4% of cases. All the RT recipients were all alive at the time of the survey. Acute rejection was reported in 8 patients (30%). Functioning graft was present in 21 (80%).

Conclusions: This is the first multinational cross-sectional study of ESRD among European HIV population. Low prevalence of ESRD was found. Two-thirds of patients were excluded from RT for non-HIV/AIDS-related pathologies. Most patients had a functioning graft despite a high acute rejection rate.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • CD4 Lymphocyte Count
  • Cross-Sectional Studies
  • Europa
  • Female
  • HIV Infections / complications
  • HIV Infections / epidemiology*
  • Hepatitis Viruses
  • Hepatitis, Viral, Human / complications
  • Hepatitis, Viral, Human / epidemiology*
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / epidemiology*
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Renal Dialysis*