Skip to content
2000
image of Epidemiology of Kidney Disease in People Living with HIV in Türkiye; Comorbidities and Drug Toxicities are Emerging Problems

Abstract

Introduction/Objective

To reveal the epidemiology of kidney disease (KD) in people living with HIV (PLWH) and to report the antiretroviral treatment (ART) management in case of kidney disease.

Methods

This multicenter, retrospective observational study identified KD under four categories: acute kidney disease (AKD), chronic kidney disease (CKD), accelerated decline of glomerular filtration rate (GFR > 60 mL/min), and asymptomatic kidney disease indicated by markers of kidney damage. Clinical characteristics and etiological causes of KD in patients were evaluated.

Results

Among 2092 PLWH screened, 131 patients (6.26%) had at least one form of KD. All patients with KD were Caucasian; 112 (84.5%) were male, with a median age of 51 9range 21–80) years. The most common comorbidities were hyperlipidemia (43.5%), diabetes mellitus (33.6%), and hypertension (26.9%). AKD developed in 20 patients (0.95%), CKD in 35 patients (1.67%), accelerated GFR decline in 69 patients (3.29%), and asymptomatic KD in 7 patients (0.33%). Regarding the etiological causes, 39.7% of KD cases were attributed to ART-related nephrotoxicity, 21.4% to HIV-related nephropathy, 19.8% to comorbidity-associated KD, and 6.9% to non-ART drug nephrotoxicity. ART regimen modification was performed in 39 patients (29.6%) with ART-related nephropathy. Lamivudine-based ART required fewer treatment changes (9.5%) than tenofovir disoproxil fumarate (38.1%) or tenofovir alafenamide (36.4%) ( = 0.04).

Discussion

ART-related nephrotoxicity and comorbidity-associated kidney diseases are emerging challenges in the epidemiology of KD among PLWH.

Conclusion

Lamivudine-based ART regimens appear to be favorable in cases of KD development, showing a greater likelihood of preserving the initial treatment regimen.

© 2025 Bentham Science Publishers
Loading

Article metrics loading...

/content/journals/chr/10.2174/011570162X369711250818051537
2025-08-25
2025-10-18

  • From This Site

    /content/journals/chr/10.2174/011570162X369711250818051537
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. Full report — In danger: UNAIDS global AIDS update 2022 Available from:https://www.unaids.org/en/resources/documents/2022/in-danger-global-aids-update
  2. Erdinc F.S. Dokuzoguz B. Unal S. Temporal trends in the epidemiology of HIV in turkey. Curr. HIV Res. 2020 18 4 258 266 10.2174/1570162X18666200427223823 32342820
    [Google Scholar]
  3. Althoff K.N. Stewart C. Humes E. The forecasted prevalence of comorbidities and multimorbidity in people with HIV in the United States through the year 2030: A modeling study. PLoS Med. 2024 21 1 1004325 10.1371/journal.pmed.1004325 38215160
    [Google Scholar]
  4. Baribeau V. Kim C.J. Lorgeoux R.P. Brisebois J. Tossonian H. Lachaine J. Healthcare resource utilization and costs associated with renal, bone and cardiovascular comorbidities among persons living with HIV compared to the general population in Quebec, Canada. PLoS One 2022 17 7 0262645 10.1371/journal.pone.0262645 35816474
    [Google Scholar]
  5. Althoff K.N. Stewart C.N. Humes E. The shifting age distribution of people with HIV using antiretroviral therapy in the United States. AIDS 2022 36 3 459 471 10.1097/QAD.0000000000003128 34750289
    [Google Scholar]
  6. Jiménez Z. Sánchez-Conde M. Brañas F. (HIV infection as a cause of accelerated aging and frailty). Rev. Esp. Geriatr. Gerontol. 2018 53 2 105 110 [PMID: 28601217
    [Google Scholar]
  7. Overton E.T. Kantor A. Fitch K.V. An evaluation of baseline kidney function in the REPRIEVE trial of pitavastatin in human immunodeficiency virus. J. Infect. Dis. 2020 222 Suppl. 1 S41 S51 10.1093/infdis/jiaa222 32645164
    [Google Scholar]
  8. Davy-Mendez T. Napravnik S. Hogan B.C. Changes in the prevalence of non-aids conditions among hospitalized persons with HIV in the United States and Canada, 2008-2018. Clin. Infect. Dis. 2025 ciaf167 10.1093/cid/ciaf167 40178532
    [Google Scholar]
  9. Rednor S.J. Ross M.J. Molecular mechanisms of injury in hiv-associated nephropathy. Front. Med. 2018 5 177 10.3389/fmed.2018.00177 29930940
    [Google Scholar]
  10. Naicker S. HIV/AIDS and chronic kidney disease. Clin. Nephrol. 2020 93 1 87 93
    [Google Scholar]
  11. Chawla L.S. Eggers P.W. Star R.A. Kimmel P.L. Acute kidney injury and chronic kidney disease as interconnected syndromes. N. Engl. J. Med. 2014 371 1 58 66 10.1056/NEJMra1214243 24988558
    [Google Scholar]
  12. Cohen S.D. Kopp J.B. Kimmel P.L. Kidney diseases associated with human immunodeficiency virus infection. N. Engl. J. Med. 2017 377 24 2363 2374 10.1056/NEJMra1508467 29236630
    [Google Scholar]
  13. Nadkarni G.N. Konstantinidis I. Wyatt C.M. HIV and the aging kidney. Curr. Opin. HIV AIDS 2014 9 4 340 345 10.1097/COH.0000000000000067 24824884
    [Google Scholar]
  14. Pourcher V. Gourmelen J. Bureau I. Bouee S. Comorbidities in people living with HIV: An epidemiologic and economic analysis using a claims database in France. PLoS One 2020 15 12 0243529 10.1371/journal.pone.0243529 33332394
    [Google Scholar]
  15. Diana N.E. Naicker S. The changing landscape of HIV-associated kidney disease. Nat. Rev. Nephrol. 2024 20 5 330 346 10.1038/s41581‑023‑00801‑1 38273026
    [Google Scholar]
  16. Kidney Disease: Definition. Gulistan-e-Johar, Karachi,: Diagnosis and Management 2023
  17. Swanepoel C.R. Atta M.G. D’Agati V.D. Kidney disease in the setting of hiv infection: Conclusions from a kidney disease: Improving global outcomes (KDIGO) controversies conference. Kidney Int. 2018 93 3 545 559 10.1016/j.kint.2017.11.007 29398134
    [Google Scholar]
  18. Hou J. Nast C.C. Changing concepts of HIV infection and renal disease. Curr. Opin. Nephrol. Hypertens. 2018 27 3 144 152 10.1097/MNH.0000000000000400 29337702
    [Google Scholar]
  19. Petersen N. Knudsen A.D. Mocroft A. Prevalence of impaired renal function in virologically suppressed people living with HIV compared with controls: The Copenhagen Comorbidity in HIV Infection (COCOMO) study. HIV Med. 2019 20 10 639 647 10.1111/hiv.12778 31359592
    [Google Scholar]
  20. Ekrikpo U.E. Kengne A.P. Bello A.K. Chronic kidney disease in the global adult HIV-infected population: A systematic review and meta-analysis. PLoS One 2018 13 4 0195443 10.1371/journal.pone.0195443 29659605
    [Google Scholar]
  21. Kaze A.D. Ilori T. Jaar B.G. Echouffo-Tcheugui J.B. Burden of chronic kidney disease on the African continent: A systematic review and meta-analysis. BMC Nephrol. 2018 19 1 125 10.1186/s12882‑018‑0930‑5 29859046
    [Google Scholar]
  22. Odubela O.O. Odunukwe N.N. Peer N. Musa A.Z. Salako B.L. Kengne A.P. Prevalence and associations of chronic kidney disease among antiretroviral therapy-naïve persons living with HIV in Lagos, Nigeria. BMC Nephrol. 2024 25 1 270 10.1186/s12882‑024‑03711‑x 39179963
    [Google Scholar]
  23. Marie Patrice H. Moussa O. Francois K. Yacouba M. Hugo M. Henry L. Prevalence and associated factors of chronic kidney disease among patients infected with human immunodeficiency virus in Cameroon. Iran. J. Kidney Dis. 2018 12 5 268 274 [PMID: 30367017
    [Google Scholar]
  24. McCutcheon K. Nqebelele U. Murray L. Thomas T.S. Mpanya D. Tsabedze N. Cardiac and renal comorbidities in aging people living with HIV. Circ. Res. 2024 134 11 1636 1660 10.1161/CIRCRESAHA.124.323948 38781295
    [Google Scholar]
  25. Chronic kidney disease: Assessment and management 2025 Available from: https://www.nice.org.uk/guidance/ng203/resources/chronic-kidney-disease-assessment-and-management-pdf-66143713055173
  26. Bonjoch A. Juega J. Echeverría P. Prevalence, progression, and management of advanced chronic kidney disease in a cohort of people living with HIV. HIV Med. 2022 23 10 1078 1084 10.1111/hiv.13317 35470944
    [Google Scholar]
  27. Calza L. Sachs M. Colangeli V. Prevalence of chronic kidney disease among HIV-1-infected patients receiving a combination antiretroviral therapy. Clin. Exp. Nephrol. 2019 23 11 1272 1279 10.1007/s10157‑019‑01768‑9 31327092
    [Google Scholar]
  28. Rehnberg J. Ludvigsson J.F. Emilsson L. IgA nephropathy and the risk of primary infections: A swedish population-based cohort study. Am. J. Nephrol. 2025 1 21 10.1159/000544753 40037312
    [Google Scholar]
  29. Bonnet F. Le Marec F. Leleux O. Evolution of comorbidities in people living with HIV between 2004 and 2014: Cross-sectional analyses from ANRS CO3 Aquitaine cohort. BMC Infect. Dis. 2020 20 1 850 10.1186/s12879‑020‑05593‑4 33198667
    [Google Scholar]
  30. Pantazis N. Chini M. Antoniadou A. The HIV patient profile in 2013 and 2003: Results from the Greek AMACS cohort. PLoS One 2018 13 9 0203601 10.1371/journal.pone.0203601 30208097
    [Google Scholar]
  31. Kasembeli A.N. Duarte R. Ramsay M. Naicker S. African origins and chronic kidney disease susceptibility in the human immunodeficiency virus era. World J. Nephrol. 2015 4 2 295 306 10.5527/wjn.v4.i2.295 25949944
    [Google Scholar]
  32. Wong C. Gange S.J. Buchacz K. First occurrence of diabetes, chronic kidney disease, and hypertension among north american hiv-infected adults, 2000–2013. Clin. Infect. Dis. 2017 64 4 459 467 10.1093/cid/ciw804 28172581
    [Google Scholar]
  33. Meylakhs P. Rodionova T. Davitadze A. Two drug epidemics in St. Petersburg, Russia? substance use, risk behaviors, and HIV and HCV prevalence among young and older people who inject drugs attending a harm reduction facility. AIDS Behav. 2025 10.1007/s10461‑025‑04696‑w 40185967
    [Google Scholar]
  34. Fabrizi F. Dixit V. Martin P. Messa P. Hepatitis C virus increases the risk of kidney disease among HIV positive patients: Systematic review and meta analysis. J. Med. Virol. 2016 88 3 487 497 10.1002/jmv.24353 26271205
    [Google Scholar]
  35. Bansi L. Hughes A. Bhagani S. Clinical epidemiology of HIV-associated end-stage renal failure in the UK. AIDS 2009 23 18 2517 2521 10.1097/QAD.0b013e3283320e12 19752713
    [Google Scholar]
  36. Jotwani V. Li Y. Grunfeld C. Choi A.I. Shlipak M.G. Risk factors for ESRD in HIV-infected individuals: Traditional and HIV-related factors. Am. J. Kidney Dis. 2012 59 5 628 635 10.1053/j.ajkd.2011.10.050 22206742
    [Google Scholar]
  37. Abraham A.G. Althoff K.N. Jing Y. End-stage renal disease among HIV-infected adults in North America. Clin. Infect. Dis. 2015 60 6 941 949 10.1093/cid/ciu919 25409471
    [Google Scholar]
  38. Cheung C.Y. Wong K.M. Lee M.P. Prevalence of chronic kidney disease in Chinese HIV-infected patients. Nephrol. Dial. Transplant. 2007 22 11 3186 3190 10.1093/ndt/gfm350 17575315
    [Google Scholar]
  39. Wyatt C.M. Winston J.A. Malvestutto C.D. Chronic kidney disease in HIV infection: An urban epidemic. AIDS 2007 21 15 2101 2103 10.1097/QAD.0b013e3282ef1bb4 17885301
    [Google Scholar]
  40. Matłosz B Skrzat-Klapaczyńska A Antoniak S Chronic kidney disease and nephrology care in people living with HIV in central/eastern Europe and neighbouring countries—cross-sectional analysis from the ECEE network Int J Environ Res 2022 19 19 12554 10.3390/ijerph191912554 36231850
    [Google Scholar]
  41. Wikman P. Safont P. Palacio M.D. Moreno A. Moreno S. Casado J.L. The significance of antiretroviral-associated acute kidney injury in a cohort of ambulatory human immunodeficiency virus-infected patients. Nephrol. Dial. Transplant. 2013 28 8 2073 2081 10.1093/ndt/gft210 23739150
    [Google Scholar]
  42. Muiru A.N. Madden E. Chilingirian A. The incidence of and risk factors for hospitalized acute kidney injury among people living with HIV on antiretroviral treatment. HIV Med. 2022 23 6 611 619 10.1111/hiv.13216 34897925
    [Google Scholar]
  43. Masimango M.I. Sumaili E.K. Jadoul M. Prevalence of microalbuminuria and diagnostic value of dipstick proteinuria in outpatients from HIV clinics in Bukavu, the Democratic Republic of Congo. BMC Nephrol. 2014 15 1 146 10.1186/1471‑2369‑15‑146 25189092
    [Google Scholar]
  44. Bickel M. Marben W. Betz C. End stage renal disease and dialysis in HIV positive patients: Observations from a long term cohort study with a follow up of 22 years. HIV Med. 2013 14 3 127 135 10.1111/j.1468‑1293.2012.01045.x 22994610
    [Google Scholar]
  45. Mallipattu S.K. Liu R. Zhong Y. Expression of HIV transgene aggravates kidney injury in diabetic mice. Kidney Int. 2013 83 4 626 634 10.1038/ki.2012.445 23325078
    [Google Scholar]
  46. Pillay S. Aldous C. Mahomed F. A deadly combination - HIV and diabetes mellitus: Where are we now? S. Afr. Med. J. 2016 106 4 378 10.7196/SAMJ.2016.v106i4.9950 27032854
    [Google Scholar]
  47. Edrosolan K.A. Shlipak M.G. Scherzer R. Mediation analysis of chronic kidney disease risk factors using kidney biomarkers in women living with HIV. AIDS 2024 38 6 813 824 10.1097/QAD.0000000000003839 38224361
    [Google Scholar]
  48. Melaku T. Chelkeba L. Mekonnen Z. Kumela K. Glycemic control among people living with diabetes and human immunodeficiency virus in ethiopia: Leveraging clinical care for the looming co-epidemics. Diabetes Metab. Syndr. Obes. 2020 13 4379 4399 10.2147/DMSO.S266105 33235478
    [Google Scholar]
  49. Khoza S.P. Crowther N.J. Bhana S. The effect of HIV infection on glycaemia and renal function in type 2 diabetic patients. PLoS One 2018 13 6 0199946 10.1371/journal.pone.0199946 29953520
    [Google Scholar]
  50. Nishijima T. Gatanaga H. Oka S. Tenofovir nephrotoxicity among Asians living with HIV: Review of the literature. Glob Health Med 2019 1 2 88 94 10.35772/ghm.2019.01021 33330761
    [Google Scholar]
  51. Seo J.W. Kim K. Jun K.I. Recovery of tenofovir-induced nephrotoxicity following switch from tenofovir disoproxil fumarate to tenofovir alafenamide in human immunodeficiency virus-positive patients. Infect. Chemother. 2020 52 3 381 388 10.3947/ic.2020.52.3.381 32757496
    [Google Scholar]
  52. Hamzah L. Jose S. Booth J.W. Treatment-limiting renal tubulopathy in patients treated with tenofovir disoproxil fumarate. J. Infect. 2017 74 5 492 500 10.1016/j.jinf.2017.01.010 28130143
    [Google Scholar]
  53. Achhra A.C. Nugent M. Mocroft A. Ryom L. Wyatt C.M. Chronic kidney disease and antiretroviral therapy in hiv-positive individuals: Recent developments. Curr. HIV/AIDS Rep. 2016 13 3 149 157 10.1007/s11904‑016‑0315‑y 27130284
    [Google Scholar]
  54. Deeks E.D. Cobicistat: A review of its use as a pharmacokinetic enhancer of atazanavir and darunavir in patients with HIV-1 infection. Drugs 2014 74 2 195 206 10.1007/s40265‑013‑0160‑x 24343782
    [Google Scholar]
  55. Gupta S.K. Mi D. Moe S.M. Dubé M.P. Liu Z. Effects of switching from efavirenz to raltegravir on endothelial function, bone mineral metabolism, inflammation, and renal function: A randomized, controlled trial. J. Acquir. Immune Defic. Syndr. 2013 64 3 279 283 10.1097/QAI.0b013e3182a97c39 24278992
    [Google Scholar]
  56. Spagnuolo V. Castagna A. Lazzarin A. Bictegravir. Curr. Opin. HIV AIDS 2018 13 4 326 333 10.1097/COH.0000000000000468 29746268
    [Google Scholar]
  57. Yin J. Wang J. Renal drug transporters and their significance in drug–drug interactions. Acta Pharm. Sin. B 2016 6 5 363 373 10.1016/j.apsb.2016.07.013 27709005
    [Google Scholar]
  58. HIV/AIDS tani tedavi rehberi 2019, general directorate of public health, republic of türkiye ministry of health. 2019. Available from:https://hsgm.saglik.gov.tr/depo/birimler/bulasici-hastaliklar-ve-erken-uyari-db/Dokumanlar/Rehberler/HIV-AIDS_Tani-Tedavi_Rehberi_2019.pdf
  59. Türk H. IV/AIDS Platformu HIV/AIDS Tanı, İzlem ve Tedavi El Kitabı. 3.0 Ed. İstanbul: Nobel Tıp Kitabevleri 2024
  60. Navise N.H. Mokwatsi G.G. Gafane-Matemane L.F. Fabian J. Lammertyn L. Kidney dysfunction: Prevalence and associated risk factors in a community-based study from the North West Province of South Africa. BMC Nephrol. 2023 24 1 23 10.1186/s12882‑023‑03068‑7 36717778
    [Google Scholar]
/content/journals/chr/10.2174/011570162X369711250818051537
Loading
Epidemiology of Kidney Disease in People Living with HIV in Türkiye; Comorbidities and Drug Toxicities are Emerging Problems
Bentham Science Publishers ; https://doi.org/10.2174/011570162X369711250818051537
/content/journals/chr/10.2174/011570162X369711250818051537
/content/journals/chr/10.2174/011570162X369711250818051537
Loading

Data & Media loading...


  • Article Type:     Research Article
Keywords: antiretroviral ; epidemiology ; HIV ; PLWH ; kidney disease ; kidney

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test