美国感染艾滋病毒的老龄人口的肾病负担。

IF 3.4 2区 医学 Q2 INFECTIOUS DISEASES
AIDS patient care and STDs Pub Date : 2024-12-01 Epub Date: 2024-11-11 DOI:10.1089/apc.2024.0202
Franck Mbuntcha Bogni, Shem Kentish, Bao Ngan Tran, Ermais S Araia, Thomas Krahn, George Bayliss, Timothy P Flanigan, Fizza S Gillani
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引用次数: 0

摘要

抗逆转录病毒疗法(ART)大大降低了艾滋病病毒感染者的死亡率,但肾脏疾病仍然很普遍,尤其是在老年人中。我们的研究分析了罗德岛米里亚姆医院免疫学中心 65 岁及以上人群的肾病负担。我们利用 2019 年的最后一次肌酐值计算了估计肾小球滤过率,并确定了慢性肾脏病(CKD)的分期。结果显示,在感染艾滋病毒的成年人中,中度或重度 CKD 患病率为 19%,而在 75 岁及以上的人群中,这一比例上升至 39%。尤其引人注目的是,在 65 岁以上的非裔美国成年人中,患病率增加到了 30.4%,75 岁以上的患病率则上升到了 50%。相比之下,美国国家糖尿病、消化道疾病和肾脏疾病研究所(National Institute of Diabetes and Digestive and Kidney Diseases)的报告显示,在 65 岁以上的成年人中,20.1% 的人处于慢性肾功能衰竭 3 期,而在 65 岁以下的成年人中,这一比例仅为 1.2%。性别和种族差异明显;女性(5.8%)比男性(4.4%)更容易患上 CKD 3 期。我们的研究结果表明,32% 的 HIV 阳性女性患有中重度肾病,而男性的这一比例仅为 14%。重要的是,我们没有考虑高血压、糖尿病和丙型肝炎病毒感染等可能影响肾脏结果的因素。我们的研究表明,抗逆转录病毒疗法降低了死亡率,因为现在越来越多的艾滋病病毒感染者活得更长了,同时也揭示了老年人和少数种族中肾脏疾病负担过重的问题,以及女性中令人担忧的趋势;因此,强调了针对高危人群采取有针对性的医疗保健策略的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Burden of Kidney Disease in an Aging Population Living with HIV in the United States.

Antiretroviral therapy (ART) has significantly improved mortality rates for individuals living with HIV, but kidney disease remains prevalent, especially among older adults. Our study analyzed the burden of kidney disease in individuals aged 65 and older at The Miriam Hospital Immunology Center in Rhode Island. We calculated estimated glomerular filtration rates using the last creatinine values from 2019 and identified chronic kidney disease (CKD) stages. Results showed a 19% prevalence of moderate or severe CKD among adults living with HIV, rising to 39% for those aged 75 and older. Particularly striking was the increased prevalence among African American adults aged 65+, at 30.4%, rising to 50% for those over 75. In comparison, the National Institute of Diabetes and Digestive and Kidney Diseases reports that CKD stage 3 affects 20.1% of adults aged 65+, compared with just 1.2% in those younger than 65. Gender and racial disparities are evident; CKD stage 3 is more prevalent in females (5.8%) than males (4.4%). Our findings indicate that 32% of HIV-positive females have moderate-to-severe kidney disease, compared with 14% of males. Importantly, we did not account for hypertension, diabetes, and hepatitis C virus infection, which may influence renal outcomes. Our study shows that ART has reduced mortality, as more people with HIV now live longer, while also revealing the disproportionate burden of kidney disease among older adults and racial minorities, as well as a concerning trend among women; therefore, emphasizing the need for targeted health care strategies for high-risk groups.

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来源期刊
AIDS patient care and STDs
AIDS patient care and STDs 医学-传染病学
CiteScore
7.00
自引率
22.40%
发文量
67
审稿时长
6-12 weeks
期刊介绍: AIDS Patient Care and STDs is the foremost journal providing the latest developments and research in diagnostics and therapeutics designed to prolong the lifespan and improve quality of life for HIV/AIDS patients. The Journal delivers cutting-edge clinical, basic science, sociologic, and behavior-based investigations in HIV/AIDS and other sexually transmitted infections. Clinical trials, quantitative and qualitative analyses of pilot studies, comprehensive reviews, and case reports are presented from leading experts and scientists around the world. AIDS Patient Care and STDs coverage includes: Prominent AIDS medications, therapies, and antiretroviral agents HIV/AIDS-related diseases, infections, and complications Challenges of medication adherence Current prevention techniques for HIV The latest news and developments on other STDs Treatment/prevention options, including pre- and post-exposure prophylaxis
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