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Open Access Highly Accessed Research article

Long-term risk of mortality for acute kidney injury in HIV-infected patients: a cohort analysis

José António Lopes1*, Maria João Melo1, Mário Raimundo1, André Fragoso2 and Francisco Antunes3

Author Affiliations

1 Department of Nephrology and Renal Transplantation, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Av. Prof. Egas Moniz, Lisboa, Portugal

2 Department of Nephrology, Hospital de Faro, Faro, Portugal

3 Department of Infectious Diseases, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Av. Prof. Egas Moniz, Lisboa, Portugal

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BMC Nephrology 2013, 14:32  doi:10.1186/1471-2369-14-32

Published: 11 February 2013

Abstract

Background

Acute kidney injury (AKI) is common in hospitalized human immunodeficiency virus (HIV)-infected patients and is associated with hospital mortality. We aimed to evaluate the impact of AKI on long-term mortality of hospitalized HIV-infected patients.

Methods

Retrospective analysis of a cohort of 433 hospitalized HIV-infected patients who were discharged alive from the hospital. AKI was defined according to ‘Risk Injury Failure Loss of kidney function End-stage kidney disease’ creatinine criteria, as an increase of baseline serum creatinine (SCr) X 1.5 or in patients with baseline SCr > 4 mg/dL if there was an acute rise in SCr of at least 0.5 mg/dL. Cumulative mortality curves were determined by the Kaplan-Meier method, and log-rank test was employed to analyze statistically significant differences between curves. Cox regression method was used to determine independent predictors of mortality. Risk factors were assessed with univariate analysis, and variables that were statistically significant (P < 0.05) in the univariate analysis were included in the multivariate analysis.

Results

Sixty-four patients (14.8%) had AKI. Median follow-up was 37 months. At follow-up 81 patients (18.7%) died. At 1, 2 and 5 years of follow-up, the cumulative probability of death of patients with AKI was 21.2, 25 and 31.3%, respectively, as compared with 10, 13.3 and 16.5% in patients without AKI (log-rank, P = 0.011). In multivariate analysis AKI was associated with increased mortality (adjusted HR 1.7, 95% CI 1.1-3; P = 0.049).

Conclusions

AKI was independently associated with long-term mortality of hospitalized HIV-infected patients.

Keywords:
Acute kidney injury; HIV; Mortality