African Americans With HIV at Greater Risk of Fatal Kidney Disease

NEW YORK (Reuters Health) Jun 18 - African Americans with HIV infection are significantly more likely to encounter end-stage renal disease than are their white counterparts, researchers report in the June 1st issue of The Journal of Infectious Diseases.

“The key point that our observational study highlights,” lead investigator Dr. Gregory M. Lucas told Reuters Health, “is the dramatically increased risk of progressive kidney disease experienced by HIV-infected black patients compared to HIV-infected white patients.”

Dr. Lucas of Johns Hopkins University School of Medicine, Baltimore, and colleagues note that little is known about this subject. To investigate further, they studied data for 3332 African American and 927 white patients with HIV infection.

During a mean of 4.5 years of follow-up, 284 subjects developed chronic kidney disease. African Americans were at somewhat greater risk than whites (hazard ratio, 1.9).

However, of the 100 patients (35%) who went on to develop end-stage renal disease, 99 were African American and only 1 was white (hazard ratio, 17.7).

In subjects for whom kidney biopsy data were available, progression was also significantly faster in African Americans regardless of the presence of HIV-associated nephropathy. Glomerular filtration rate also decline six times as quickly.

“Healthcare priorities in this area,” concluded Dr. Lucas, “include improved screening for kidney disease in HIV-infected African Americans and research on the implementation of early interventions.”

In an accompanying editorial, Dr. Christina M. Wyatt of Mount Sinai School of Medicine, New York agrees. “In light of the potential for an epidemic of HIV-related kidney disease and end-stage renal disease in disadvantaged minority populations and in Africa, the international medical community should work to develop simple, inexpensive, and reliable methods to detect and manage early kidney disease in these vulnerable populations.”

Source:

1. African Americans With HIV at Greater Risk of Fatal Kidney Disease