Epidemiology, clinical characteristics, and management of chronic kidney disease in human immunodeficiency virus-infected patients

Table 1 Comparisons of prevalence of chronic kidney disease in human immunodeficiency virus-infected patients across previous studies

	Prevalence (%)	Countries	Ref.
Proteinuria
	7.20	United States	[7]
	9.50	Japan	[11]
	13.70	China	[10]
Albuminuria
	8.70	Norway	[25]
	11.00	United States	[26]
	17.80	Japan	[11]
CKD stages 1-5
	15.40	Japan	[11]
	15.50	United States	[23]
	16.80	China	[10]
	23.70	United States	[13]
CKD stages ≥ 3
	3.50	EuroSIDA	[12]
	5.60	China	[10]
	5.90	United States	[23]
	9.70	Japan	[11]
	9.70	United States	[13]

CKD: Chronic kidney disease; EuroSIDA: European study of patients with HIV-1 infection including 93 centers across Europe.

Table 2 Glomerular or tubular diseases in human immunodeficiency virus-infected patients

Diseases	Clinical characteristics
HIV-specific glomerular disease
HIVAN	Detectable viral load, a high amount of proteinuria, albuminuria, RPGN
HIVIC	Proteinuria and/or hematuria, variable manifestation including AKI
TMA	AKI, proteinuria, hematuria with microangiopathic hemolytic anemia and thrombocytopenia
HIV-non-specific glomerular disease
HCV-related MPGN/cryoglobulinemia	Proteinuria and/or hematuria, nephritic syndrome, a decrease in serum complements
Diabetec nephropathy	Proteinuria (microalbuminuria to nephrotic syndrome), a decrease in GFR
Glomerular sclerosis	Older patients, hypertension, no or low amount of proteinuria, coexistence of atherosclerotic diseases
Membranous glomerulopathy	Nephrotic syndrome; idiopathic and secondary causes associated with HBV or cancers
Minimal change disease	Nephrotic syndrome, use of NSAIDs
IgA nephropathy	Hematuria and/or proteinuria with or without renal failure
Post-infectious glomerulonephritis	Hematuria and/or proteinuria with or without renal failure
ART-associated tubular injury
Acute tubular necrosis	Use of TDF
Cristal nephropathy	Use of IDV and ATV
Acute or chronic interstitial nephritis	Use of ATV

HIVAN: HIV-associated nephropathy; HIVIC: HIV-associated immune complex kidney disease; TMA: Thrombotic microangiopathy; HCV: Hepatitis C virus; HBV: Hepatitis B virus; AKI: Acute kidney injury; GFR: Glomerular filtration rate; NSAID: Non-steroidal anti-inflammatory drug; ART: Antiretroviral therapy; TDF: Tenofovir disoproxil fumarate; IDV: Indinavir; ATV: Atazanavir.

Table 3 Traditional and human immunodeficiency virus-related factors associated with chronic kidney disease

Variables	Ref.
Black race	[34,35]
Older age	[9-12,22-26]
Low CD4 cell count	[10,11,23-25]
High HIV-RNA viral load	[10,11,23-25]
Diabetes mellitus	[9-12,22-26]
Hypertension	[9-12,22-26]
Hepatitis C virus coinfection	[11,25,31,37]
Proteinuria	[3,27,28,30]
Albuminuria	[3,29,55]
eGFR < 90 mL/min per 1.73 m2	[10,12,23-25]
Elevation of urinary tubular markers	[56-64]
Use of TDF or ATV	[40-52]

eGFR: Estimated glomerular filtration rate; TDF: Tenofovir disoproxil fumarate; ATV: Atazanavir.