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Abstract: PO0488

High Prevalence of CKD Among Individuals Living with HIV in the United States

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Bragg-Gresham, Jennifer L., University of Michigan Medical School, Ann Arbor, Michigan, United States
  • Andrews, Ann, National Kidney Foundation of Michigan, Ann Arbor, Michigan, United States
  • Morgenstern, Hal, University of Michigan, Ann Arbor, Michigan, United States
  • Gillespie, Brenda W., University of Michigan, Ann Arbor, Michigan, United States
  • Powe, Neil R., University of California San Francisco, San Francisco, California, United States
  • Banerjee, Tanushree, University of California San Francisco, San Francisco, California, United States
  • Saran, Rajiv, University of Michigan Medical School, Ann Arbor, Michigan, United States
Background

Chronic kidney disease (CKD) is an important comorbidity among people living longer with human immunodeficiency virus (HIV). We report the prevalence, trends and characteristics of individuals with HIV in the US, with the aim of better understanding this understudied, but important risk factor for CKD.

Methods

Data from 22,626 adults aged 20-59 who had consented for HIV testing in the National Health and Nutrition Examination Survey (NHANES; 1999-2014), were analyzed. Those with HIV + vs. - serology were compared with respect to demographics, comorbidities, and social determinants of health in the full sample and those with CKD, as defined by either eGFR<60 ml/min/1.73m2 or urine albumin to creatinine ratio of >30 mg/g. Logistic regression was used to assess the odds of CKD by HIV status. Comparisons were assessed using survey weights for all analyses.

Results

Prevalence of HIV+ remained stable, from 0.4% to 0.6% during this time period. Individuals HIV+ were older than those HIV- in both the full sample and among those with CKD. A higher proportion of HIV+ than HIV- individuals were black, current smokers, had < high school education, with income <$45k, and reported either Medicare or other government insurance (Table). Among individuals with CKD, those HIV+ had almost twice the prevalence of diabetes (30% vs. 19%, p=NS) and over 4 times higher awareness of their CKD (28% vs. 6%, p=0.002) compared to HIV-. HIV+ vs. HIV- individuals had more than twice the prevalence of CKD (15.3% vs. 7.1%, p=0.002). CKD was associated with HIV + status [unadjusted odds ratio (OR) = 2.37; 95% CI: 1.36-4.17]. Adjusting for other covariates, attenuated the association only slightly (adjusted OR=2.17; 95% CI: 1.21-3.89).

Conclusion

CKD was associated with HIV+ status among younger adults living with the disease in the US. However, larger, longitudinal studies among individuals living with HIV and CKD are needed to increase awareness of this complication among survivors of the disease.