Table 2. Factors associated with rates of serum creatinine monitoring after ART initiation.
| Univariate | Multivariate | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Person-years | Number S-Cr assessments | cCrude rate | 95% CI | IRR | 95% CI | p | IRR | 95% CI | p | |
| Age at ART initiation (years) | <0.001 | |||||||||
| ≤30 | 3769.9 | 4846 | 1.29 | (1.25, 1.32) | 1 | |||||
| 31–40 | 5877.8 | 8052 | 1.37 | (1.34, 1.40) | 1.06 | (0.97, 1.15) | 0.231 | |||
| 41–50 | 2420.6 | 3903 | 1.61 | (1.56, 1.66) | 1.29 | (1.16, 1.44) | <0.001 | |||
| 51+ | 951.0 | 1608 | 1.69 | (1.61, 1.78) | 1.24 | (1.07, 1.43) | 0.003 | |||
| Sex | ||||||||||
| Male | 8719.6 | 12918 | 1.48 | (1.46, 1.51) | 1 | |||||
| Female | 4299.7 | 5491 | 1.28 | (1.24, 1.31) | 0.82 | (0.76, 0.89) | <0.001 | |||
| Mode of HIV Exposure | <0.001 | 0.009 | ||||||||
| Heterosexual contact | 9598.4 | 12463 | 1.30 | (1.28, 1.32) | 1 | 1 | ||||
| Homosexual contact | 2077.0 | 3675 | 1.77 | (1.71, 1.83) | 1.52 | (1.38, 1.67) | <0.001 | 0.95 | (0.87, 1.04) | 0.304 |
| Injecting drug use | 657.5 | 1004 | 1.53 | (1.44, 1.62) | 1.18 | (1.02, 1.37) | 0.028 | 1.22 | (1.08, 1.38) | 0.002 |
| Other/unknown | 686.5 | 1267 | 1.85 | (1.75, 1.95) | 1.43 | (1.23, 1.67) | <0.001 | 1.02 | (0.89, 1.16) | 0.800 |
| Pre-ART weight (kg) | ||||||||||
| >55 | 3227.3 | 5731 | 1.78 | (1.73, 1.82) | 1 | |||||
| ≤55 | 4106.6 | 5662 | 1.38 | (1.34, 1.42) | 0.80 | (0.73, 0.89) | <0.001 | |||
| Missing | 5685.4 | 7016 | 1.23 | (1.21, 1.26) | ||||||
| Pre-ART viral load (copies/mL) | ||||||||||
| ≤100000 | 2793.8 | 4967 | 1.78 | (1.73, 1.83) | 1 | 1 | ||||
| >100000 | 2614.8 | 5370 | 2.05 | (2.00, 2.11) | 1.22 | (1.10, 1.34) | <0.001 | 1.27 | (1.16, 1.38) | <0.001 |
| Missing | 7610.7 | 8072 | 1.06 | (1.04, 1.08) | ||||||
| Pre-ART CD4 (cells/μL) | 0.001 | |||||||||
| ≤50 | 3318.4 | 4702 | 1.42 | (1.38, 1.46) | 1 | |||||
| 51–100 | 1690.3 | 2161 | 1.28 | (1.23, 1.33) | 1.01 | (0.89, 1.15) | 0.848 | |||
| 101–200 | 2784.5 | 4356 | 1.56 | (1.52, 1.61) | 1.12 | (1.01, 1.25) | 0.030 | |||
| >200 | 2427.3 | 4116 | 1.70 | (1.64, 1.75) | 1.21 | (1.09, 1.35) | <0.001 | |||
| Missing | 2798.8 | 3074 | 1.10 | (1.06, 1.14) | ||||||
| Initial ART Regimen | <0.001 | <0.001 | ||||||||
| NRTI+NNRTI | 10842.9 | 13985 | 1.29 | (1.27, 1.31) | 1 | 1 | ||||
| NRTI+PI | 1903.6 | 3983 | 2.09 | (2.03, 2.16) | 2.03 | (1.84, 2.24) | <0.001 | 1.27 | (1.16, 1.38) | <0.001 |
| Other | 272.8 | 441 | 1.62 | (1.47, 1.77) | 1.18 | (0.91, 1.53) | 0.219 | 0.83 | (0.67, 1.02) | 0.080 |
| Hepatitis B co-infection | ||||||||||
| Negative | 8303.4 | 13200 | 1.59 | (1.56, 1.62) | 1 | |||||
| Positive | 1676.6 | 2676 | 1.60 | (1.54, 1.66) | 0.93 | (0.84, 1.04) | 0.190 | |||
| Not tested | 3039.3 | 2533 | 0.83 | (0.80, 0.87) | ||||||
| Hepatitis C co-infection | ||||||||||
| Negative | 8389.9 | 13102 | 1.56 | (1.54, 1.59) | 1 | |||||
| Positive | 1138.6 | 1869 | 1.64 | (1.57, 1.72) | 0.97 | (0.86, 1.10) | 0.657 | |||
| Not tested | 3490.9 | 3438 | 0.98 | (0.95, 1.02) | ||||||
| Previous AIDS | ||||||||||
| No | 7714.0 | 10758 | 1.39 | (1.37, 1.42) | 1 | |||||
| Yes | 5305.3 | 7651 | 1.44 | (1.41, 1.47) | 1.04 | (0.96, 1.12) | 0.359 | |||
| Country Income Level | <0.001 | <0.001 | ||||||||
| Low + Lower Middle | 4166.7 | 4326 | 1.04 | (1.01, 1.07) | 1 | 1 | ||||
| Upper Middle | 7078.0 | 10336 | 1.46 | (1.43, 1.49) | 1.39 | (1.29, 1.51) | <0.001 | 1.34 | (1.24, 1.45) | <0.001 |
| High | 1774.7 | 3747 | 2.11 | (2.04, 2.18) | 2.21 | (1.97, 2.48) | <0.001 | 2.05 | (1.83, 2.30) | <0.001 |
| pre-ART eGFR(ml/min per 1.73 m2) | ||||||||||
| <60 | 105.5 | 289 | 2.74 | (2.44, 3.07) | 1 | 1 | ||||
| ≥60 | 4539.7 | 9507 | 2.09 | (2.05, 2.14) | 0.75 | (0.54, 1.03) | 0.071 | 0.72 | (0.54, 0.95) | 0.019 |
| Missing | 8374.1 | 8613 | 1.03 | (1.01, 1.05) | ||||||
| dReceiving TDF | ||||||||||
| No | 7025.1 | 7098 | 1.01 | (0.99, 1.03) | 1 | 1 | ||||
| Yes | 5994.2 | 11311 | 1.89 | (1.85, 1.92) | 1.93 | (1.86, 2.00) | <0.001 | 1.68 | (1.62, 1.74) | <0.001 |
| dReceiving IDV | ||||||||||
| No | 12706.8 | 17945 | 1.41 | (1.39, 1.43) | 1 | |||||
| Yes | 312.5 | 464 | 1.49 | (1.36, 1.63) | 0.95 | (0.84, 1.07) | 0.388 | |||
| a,dHigh fasting glucose level | ||||||||||
| No | 7566.6 | 13579 | 1.79 | (1.76, 1.83) | 1 | 1 | ||||
| Yes | 522.2 | 998 | 1.91 | (1.80, 2.03) | 1.11 | (1.02, 1.21) | 0.021 | 1.15 | (1.05, 1.25) | 0.002 |
| Missing | 4930.5 | 3832 | 0.78 | (0.75, 0.80) | ||||||
| b,dHigh blood pressure | ||||||||||
| No | 8047.3 | 11923 | 1.48 | (1.46, 1.51) | 1 | |||||
| Yes | 1429.3 | 2379 | 1.66 | (1.60, 1.73) | 1.08 | (1.02, 1.14) | 0.005 | |||
| Missing | 3542.7 | 4107 | 1.16 | (1.12, 1.20) | ||||||
Note:
a—high fasting glucose defined as ≥7 mmol/L or ≥126 mg/dL.
b—High blood pressure defined as systolic >140 mmHg, or diastolic >90 mmHg.
c—Crude rate, per person-year
d—Time-updated variables
Missing values were coded as a separate category and were excluded from test for heterogeneity.
S-Cr, serum creatinine; CI, confidential interval; IRR, incident rate ratio; ART, antiretroviral therapy; NRTI, nucleos(t)ide reverse transcriptase inhibitor; NNRTI, non-nucleoside reverse transcriptase inhibitor; PI, protease inhibitor; TDF, tenofovir disoproxil fumarate; IDV, indinavir.