TABLE 2.
Association of baseline demographic and clinical characteristics with risk of acute kidney injury (AKI)
| Risk factor | Unadjusted HR (95% CI) | P-value | Adjusted HR (95% CI) | P-value |
|---|---|---|---|---|
| ART index date (per year) | 1.00 (0.94, 1.07) | 0.97 | 1.01 (0.94, 1.08) | 0.86 |
| Sociodemographic characteristics | ||||
| Age at index (per decade) | 1.43 (1.24, 1.65) | <0.001 | 1.11 (0.93, 1.33) | 0.24 |
| Female | 1.16 (0.84, 1.6) | 0.36 | 1.18 (0.84, 1.66) | 0.33 |
| Self-identified black race | 4.03 (2.36, 6.89) | <0.001 | 2.44 (1.42, 4.20) | 0.001 |
| Injecting drug use | 2.13 (1.56, 2.91) | <0.001 | 1.02 (0.65, 1.59) | 0.93 |
| Smoking status at index | ||||
| Current smoker vs. nonsmoker | 1.67 (0.83, 3.36) | 0.16 | 1.52 (0.74, 3.12) | 0.25 |
| Former smoker vs. nonsmoker | 0.66 (0.18, 2.41) | 0.53 | 0.55 (0.14, 2.26) | 0.40 |
| Insurance type at index | ||||
| Private vs. governmenta | 0.40 (0.24, 0.69) | <0.001 | 0.71 (0.41, 1.22) | 0.21 |
| Uninsured vs. government | 0.52 (0.13, 2.07) | 0.35 | 1.29 (0.28, 6.0) | 0.74 |
| Comorbid conditions | ||||
| Chronic kidney disease | 5.06 (3.01, 8.49) | <0.001 | 1.77 (0.96, 3.26) | 0.07 |
| Diabetes mellitus | 1.75 (1.11, 2.76) | 0.02 | 1.13 (0.66, 1.92) | 0.66 |
| Hypertension | 2.36 (1.73, 3.23) | <0.001 | 1.62 (1.09, 2.38) | 0.02 |
| COPD | 3.85 (2.53, 5.85) | <0.001 | 1.48 (0.90, 2.43) | 0.12 |
| Ischaemic heart disease | 3.18 (1.84, 5.49) | <0.001 | 1.67 (0.90, 3.09) | 0.10 |
| HCV infection | 2.29 (1.69, 3.12) | <0.001 | 1.27 (0.82, 1.95) | 0.28 |
| History of AKI (> 6 months prior to index) | 3.4 (2.25, 5.12) | <0.001 | 1.13 (0.68, 1.89) | 0.63 |
| Dipstick proteinuria (≥ 1) | 3.28 (2.04, 5.27) | <0.001 | 1.86 (1.07, 3.23) | 0.03 |
| Clinical measurements Body mass index (kg/m2) | ||||
| 18.5–24.9 (ref) | 1.0 | |||
| 25.0–29.9 | 0.87 (0.58, 1.31) | 0.50 | 0.98 (0.65, 1.48) | 0.93 |
| ≥ 30.0 | 0.84 (0.53, 1.34) | 0.47 | 0.92 (0.57, 1.50) | 0.75 |
| < 18.5 | 1.16 (0.47, 2.82) | 0.74 | 1.11 (0.54, 2.26) | 0.77 |
| Serum albumin (per 1 g/dL decrease) | 2.51 (1.94, 3.25) | <0.001 | 1.73 (1.24–2.40) | 0.001 |
| HIV-related factors | ||||
| HIV VL ≥ 400 vs. < 400 copies/mL | 1.99 (1.37, 2.88) | <0.001 | 1.33 (0.85, 2.08) | 0.22 |
| History of AIDS | 2.72 (1.98, 3.74) | <0.001 | 1.82 (1.29, 2.56) | <0.001 |
| CD4 count < 200 vs ≥ 200 cells/μL | 2.28 (1.65, 3.15) | <0.001 | 1.46 (1.02, 2.07) | 0.04 |
| Medication use | ||||
| Diuretics | 2.38 (1.55, 3.65) | <0.001 | 1.53 (0.93, 2.51) | 0.09 |
| ACE-I or ARB | 1.76 (1.14, 2.71) | 0.01 | 0.76 (0.45, 1.29) | 0.32 |
| Prevalent use of ART | 0.74 (0.54, 1.01) | 0.06 | 1.04 (0.68, 1.59) | 0.85 |
| Separate analysis of TDF and atazanavir, using IPTW | ||||
| TDF | 0.73 (0.51, 1.05) | 0.09 | 0.80 (0.54, 1.19) | 0.28 |
| Atazanavir | 0.89 (0.58, 1.36) | 0.58 | 0.81 (0.52, 1.27) | 0.36 |
Multivariable Cox regression models were adjusted for: sociodemographic factors, kidney-related risk factors (estimated glomerular filtration rate, dipstick proteinuria, history of prior AKI, diabetes mellitus and hypertension), HIV-related factors (serum albumin, HIV viral load, history of AIDS and CD4 count), other comorbid conditions (HCV infection, chronic obstructive pulmonary disease and ischaemic heart disease), medications (diuretics, ACE-I or ARB) and body mass index. ACE-I, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; ART, antiretroviral therapy; CI, confidence interval; COPD, chronic obstructive pulmonary disease; HCV, hepatitis C virus; HR, hazard ratio; IPTW, inverse probability of treatment weight; TDF, tenofovir disoproxil fumarate; VL, viral load.
Medicare/Medicaid/other public/Ryan White.