M.M. GADZHIKULIEVA¹, A.D. NIKITINA², E.V. TSYGANOVA³, N.A. TSVETKOVA⁴

 ¹Russian University of Medicine, Moscow

²Polyclinic No. 1 of the Administrative Department of the President of the Russian Federation, Moscow

³Moscow City Centre for AIDS Prevention and Treatment, Moscow

⁴Infectious Clinical Hospital No. 2, Moscow

Contact details:

Nikitina A.D. — infectious disease specialist

Address: 26/28 Sivtsev Vrazhek, 119002 Moscow, Russian Federation, tel.: +7-969-055-37-48, e-mail: evenorde@gmail.com

The purpose — to assess predictors of kidney damage in HIV-infected patients.

Material and methods. A retrospective analysis of 1,787 autopsy protocols of adult HIV-infected patients was conducted. Modifiable and non-modifiable risk factors for kidney damage were assessed. The main group consisted of 359 patients with kidney damage according to autopsy, which developed against the background of secondary diseases (n = 81) and generalized bacterial complications (n = 278). The comparison group (n=100), matching with the main group in demographic characteristics, was formed by random sampling from patients without kidney pathology according to autopsy.

Results. Among patients with kidney damage according to autopsy, males (p < 0.001) and patients older than 40 years (p < 0.05) predominated. Univariate analysis showed the strongest association of diabetes mellitus with kidney damage (OR = 3.67; 95% CI: 2.13–6.30; p < 0.001), male gender — with a 2.58-fold (OR = 2.58; 95% CI: 1.63–4.10; p=0.0001), and arterial hypertension with a 1.57-fold risk increase (OR = 1.57; 95% CI: 1.00–2.47; p = 0.063). Multivariate analysis identified three independent risk factors: diabetes mellitus (aOR = 29.51; 95% CI: 21.99–39.60), arterial hypertension (aOR = 6.89; 95% CI: 5.14–9.25), and male gender (aOR = 2.01; 95% CI: 1.50–2.69). The model had good discriminatory ability (AUC-ROC = 0.915; p < 0.001).

Conclusion. Predictors of kidney damage in HIV-infected patients are male gender, age over 40 years, and the presence of arterial hypertension and diabetes mellitus. The most significant modifiable risk factors are arterial hypertension and diabetes mellitus, which indicates the need to pay special attention to the detection and correction of these conditions in the management of HIV-infected patients.

Key words: HIV infection, kidney damage, predictors, diabetes mellitus, arterial hypertension, pathoanatomical autopsy study.

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