| Abstract | Kronična bubrežna bolest (KBB) predstavlja važan globalni javnozdravstveni problem u osoba zaraženih HIV-om. Različite studije pokazuju da je korištenje antiretrovirusne terapije (ART) praćeno povećanjem učestalosti KBB-a i smanjenjem stupnja glomerularne filtracije (GFR).
Cilj istraživanja: Prikazati učestalost KBB-a u osoba zaraženih HIV-om koje uzimaju ART, te opisati trendove pojedinih stupnjeva KBB-a u osoba zaraženih HIV-om u skrbi u Klinici za infektivne bolesti u Zagrebu tijekom razdoblja 2012. – 2016. godine. Nacrt studije: Retrospektivna kohortna studija. Ispitanici i metode: U istraživanje su uključene HIV+ osobe oba spola, dobi ≥ 18 godina koje su liječene u Klinici za infektivne bolesti u Zagrebu u razdoblju siječanj 2012. - prosinac 2016. godine. Iz istraživanja su isključene HIV+ trudnice. KBB je definirana prema MDRD jednadžbi. Podaci o ispitanicima i laboratorijskim vrijednostima prikupljani su iz povijesti bolesti uz odobrenje Etičkog povjerenstva Klinike. Kao programska potpora u provedbi istraživanja korišten je programski paket SAS (inačica 4.9, SAS Institute Inc., SAD). Rezultati: Prikupljeni su podaci o 4.166 određivanja stupnja KBB-a izračunavanjem eGFR, od čega 3.691 u muškaraca i 475 u žena, najviše u dobnoj skupini 30 – 39 godina (32,89 %). Ko-infekcija HCV-om detektirana je u 6,34 %, a HBV-om u 4,49 % ispitanika, te ne pokazuje trend porasta. Viremiju < 50 kopija HIV-a/mL imalo je 83,20 % ispitanika. ART je primalo 91,77 % ispitanika, a najčešća kombinacija bila je ABC/3TC/EFV (29,12 %). KBB u HIV+ osoba na ART-u pokazuje sljedeću učestalost: stupanj 1. (normalna bubrežna funkcija) – 30,08 % ispitanika, stupanj 2. (blago snižena) – 56,87 %, stupanj 3A. (umjerena) - 3,46 %, stupanj 3B. (umjerena) - 0,67 %, stupanj 4. (značajno snižena) - 0,31 % i 5. završni stupanj KBB-a 0,38 % ispitanika. Zaključak: Mjerenja stupnja eGFR kod ispitanika koji su koristili ART pokazala su češće blaže odstupanje od normale za eGFR u usporedbi s mjerenjima kod ispitanika koji nisu uzimali ART. Iako se radilo o malom broju ispitanika trend povećanja KBB-a je uočljiv. |
| Abstract (english) | Objectives: Chronic kidney disease (CKD) is an important global public health problem among HIV-infected persons. Various studies have shown that the use of antiretroviral therapy (ART) is followed by an increased CKD frequency and decreased glomerular filtration rate (GFR). The aim of our study was to investigate the frequency of CKD in HIV-infected persons taking ART and to describe the trends of individual stages of CKD in HIV-infected persons in care at the University Hospital for Infectious Diseases (UHID) in Zagreb in the period 2012 – 2016. Study Design: Retrospective cohort study. Participants and Methods: The study included HIV-infected persons of both sexes, aged ≥ 18 years who were treated at the UHID in Zagreb during the period January 2012 – December 2016. HIV-positive pregnant women were excluded from the study. CKD was calculated using the Modification of Diet in Renal Disease (MDRD) equation. Data on participants and laboratory findings were collected from medical history documents with the approval of the hospital Ethics Committee. The SAS program package (version 4.9, SAS Institute Inc., USA) was used for statistical analysis of collected research data. Results: Data of 4.166 CKD stage measurements in HIV-infected patients, 3.691 in males and 475 in females, were collected by calculating eGFR, mostly in the age group 30 – 39 years (32,89 %). HCV co-infection was detected at 6.34 % and HBV in 4.49 % of participants, and did not show a growing trend. Viremia below 50 copies of HIV/mL was found in 83.20 % of participants. ART received 91.77 % of participants, with the most commonly used combination being ABC/3TC/EFV (29.12 %). CKD in HIV-positive persons on ART showed the following frequency: Stage 1. (normal) in 30.08 % of participants, Stage 2. (slightly reduced) in 56.87 %, Stage 3A. (moderate) in 3.46 %, Stage 3B. (moderate) in 0.67 %, Stage 4. (significantly reduced) in 0.31 % and 5th final stage of CKD in 0.38 % of respondents. Summary 46 Conclusion: The eGFR measurements performed on HIV-infected persons using ART demonstrated a milder deviation from the normal eGFR values compared to measurements made on subjects who did not take ART. Although the study was performed on a small number of respondents, the growing trend of CKD is noticeable. |
