Background
Methods
Study setting
Patients
Definition of operational terms
Statistical analysis
Results
Baseline characteristics
Variables | Total | Gender |
P
| Stage |
P
| ||||
---|---|---|---|---|---|---|---|---|---|
Male | Female | G3a | G3b | G4 | G5 | ||||
N (%) | 156 (100.0) | 80 (51.3) | 76 (48.7) | 13 (8.3) | 20 (12.8) | 32 (20.5) | 91 (58.3) | ||
Age (years), Mean ± SDa | 45.4 ± 12.1 | 48.3 ± 11.8 | 42.4 ± 11.6 |
0.002
| 46.6 ± 14.9 | 49.0 ± 12.8 | 43.2 ± 12.7 | 45.3 ± 11.2 | 0.394 |
Age (years), Min-Max | 22–82 | 25–82 | 22–72 | 26–72 | 28–70 | 25–82 | 22–77 | ||
Marital status, n (%) | |||||||||
Married | 87 (55.8) | 58 (72.5) | 29 (38.2) | 9 (69.2) | 9 (45.0) | 17 (53.1) | 52 (57.1) | ||
Single | 53 (34.0) | 17 (21.3) | 36 (47.4) | 3 (23.1) | 8 (40.0) | 13 (40.6) | 29 (31.9) | ||
Divorced | 2 (1.3) | 1 (1.3) | 1 (1.3) | 0 (0.0) | 0 (0.0) | 1 (3.1) | 1 (1.1) | ||
Widow | 14 (9.0) | 4 (5.0) | 10 (13.2) |
< 0.001
| 1 (7.7) | 3 (15.0) | 1 (3.1) | 9 (9.9) | 0.784 |
Employment status, n (%) | |||||||||
Unemployed | 56 (35.9) | 11 (13.8) | 45 (59.2) | 6 (46.2) | 4 (20.0) | 12 (37.5) | 34 (37.4) | ||
Public agent | 10 (6.4) | 8 (10.0) | 2 (2.6) | 0 (0.0) | 1 (5.0) | 1 (3.1) | 8 (8.8) | ||
Private sector | 37 (23.7) | 29 (36.3) | 8 (10.5) | 5 (38.5) | 5 (25.0) | 8 (25.0) | 19 (20.9) | ||
Informal sector | 39 (25.0) | 18 (22.5) | 21 (27.6) | 1 (77) | 6 (300) | 8 (25.0) | 24 (26.4) | ||
Retired | 14 (9.0) | 14 (17.5) | 0 (0.0) |
< 0.001
| 1 (7.7) | 6 (30.0) | 8 (25.0) | 24 (26.4) | 0.548 |
Co morbidity, n (%) | |||||||||
Hypertension | 57 (36.5) | 25 (31.6) | 32 (42.1) | 0.177 | 4 (33.3) | 6 (30.0) | 10 (31.3) | 37 (40.7) | 0.690 |
Diabetes | 28 (17.9) | 18 (22.8) | 10 (13.2) | 0.119 | 2 (16.7) | 6 (30.0) | 7 (21.9) | 13 (14.3) | 0.372 |
HCVb coinfection | 12 (7.7) | 7 (8.8) | 5 (6.6) | 0.611 | 1 (7.7) | 2 (10.0) | 1 (3.1) | 8 (8.8) | 0.742 |
Chronic use of NSAIDc | 9 (5.8) | 4 (5.1) | 5 (6.6) | 0.744 | 1 (8.3) | 1 (5.0) | 1 (3.1) | 6 (6.6) | 0.876 |
HBVd coinfection | 6 (3.8) | 5 (6.3) | 1 (1.3) | 0.211 | 0 (0.0) | 2 (10.0) | 3 (9.4) | 1 (1.1) | 0.070 |
Background nephropathy, n (%) | |||||||||
HIVANe | 43 (27.6) | 26 (32.5) | 17 (22.4) | 4 (30.8) | 5 (25.0) | 6 (18.8) | 28 (30.8) | ||
Chronic glomerulonephritis | 24 (15.4) | 9 (11.3) | 15 (19.7) | 1 (7.7) | 5 (25.0) | 5 (15.6) | 13 (14.3) | ||
Diabetes | 22 (14.1) | 15 (18.8) | 7 (9.2) | 1 (7.7) | 6 (30.0) | 4 (12.5) | 11 (12.1) | ||
Hypertension | 21 (13.5) | 7 (8.8) | 14 (18.4) | 3 (23.1) | 2 (10.0) | 12 (37.5) | 21 (23.1) | ||
Chronic interstitial nephritis | 7 (4.5) | 3 (3.8) | 4 (5.3) | 1 (7.7) | 0 (0.0) | 1 (3.1) | 5 (5.5) | ||
Polykystosis | 1 (0.6) | 1 (1.3) | 0 (0.0) | 0 (0.0) | 1 (5.0) | 0 (0.0) | 0 (0.0) | ||
Unknown | 38 (24.4) | 19 (23.8) | 19 (25.0) | 0.139 | 3 (23.1) | 2 (10.0) | 12 (37.5) | 21 (23.1) | 0.242 |
Known HIVe infected, n (%) | 109 (69.9) | 56 (70.0) | 53 (69.7) | 0.971 | 8 (61.5) | 16 (80.0) | 21 (65.6) | 64 (70.3) | |
HIV infection vintage (month)g | 36 (11–96) | 36 (12–108) | 36 (10.3–96) | 0.856 | 24 (1–144) | 15 (4–48) | 24 (7.5–60) | 36 (12–108) | 0.251 |
Use of cARTf, n (%) | 76 (48.7) | 36 (45.0) | 40 (52.6) | 0.340 | 7 (53.8) | 10 (50.0) | 11 (34.4) | 48 (52.7) | |
Duration on cARTfg | 36 (6.8–96) | 36 (12–99) | 36 (6–96) | 0.879 | 40 (18.3–90) | 8 (2–79.5) | 48 (4–72) | 36 (9.8–105) | 0.797 |
Drug regimen, n (%), n = 76 | |||||||||
1st line | 65 (85.5) | 33 (91.7) | 32 (80.0) | 6 (85.7) | 8 (80.0) | 8 (72.7) | 43 (89.6) | ||
2nd line | 11 (14.5) | 3 (8.3) | 8 (20.0) | 0.199 | 1 (14.3) | 2 (20.0) | 3 (27.3) | 5 (10.4) | |
CD4 countg, n = 88 | 241 (117–438) | 256 (138–387) | 216 (96–535) | 0.619 | 101 (66–376) | 176.5 (137–333.3) | 278 (117.3–549) | 271 (120–451) | 0.456 |
Biological profile
Biologic Data | Total | Gender |
P
| Stage |
P
| ||||
---|---|---|---|---|---|---|---|---|---|
Male | Female | G3a | G3b | G4 | G5 | ||||
Blood urea nitrogen (g/l)h | 1.12 (0.7–2.1) | 1.1 (0.7–2.0) | 1.3 (0.7–2.2) | 0.918 | 0.4 (0.3–0.6) | 0.7 (0.5–1.2) | 0.8 (0.6–1.1) | 1.8 (1.05–2.5) |
< 0.001
|
Serum Creatinine (mg/l)h | 67.7 (29.3–118.5) | 73.4 (29.6–101.3) | 61.9 (28.4–135.1) | 0.457 | 16.7 (15.8–19.6) | 24.7 (21–25.4) | 33.9 (29.6–40.6) | 103 (79.8–160.9) |
< 0.001
|
GFRa (ml/min/1.73 m2)h | 10.1 (4.7–27.2) | 10.2 (6.5–31.5) | 9.5 (3.4–23.3) |
0.028
| 49.5 (47.9–51.8) | 37.1 (31.9–40.5) | 22.4 (19.8–26.51) | 5.3 (3.2–8.3) |
< 0.001
|
CKDb stage, n (%) | – | – | – | – | |||||
G1 | 0 (0.0) | 0 (0.0) | 0 (0.0) | – | – | – | – | ||
G2 | 0 (0.0) | 0 (0.0) | 0 (0.0) | – | – | – | – | ||
G3a | 13 (8.3) | 8 (10.0) | 5 (6.6) | – | – | – | – | ||
G3b | 20 (12.8) | 13 (16.3) | 7 (9.2) | – | – | – | – | ||
G4 | 32 (20.5) | 17 (21.3) | 15 (19.7) | – | – | – | – | ||
G5 | 91 (58.3) | 42 (52.5) | 49 (64.5) | 0.383 | – | – | – | – | |
Urinary dipstick, n (%) | |||||||||
Proteinuria | 121 (77.6) | 65 (81.3) | 56 (73.7) | 0.258 | 7 (53.8) | 15 (75.0) | 27 (84.4) | 72 (79.1) | 0.154 |
Hematuria | 42 (26.9) | 26 (32.5) | 16 (21.1) | 0.107 | 2 (15.4) | 5 (25.0) | 5 (15.6) | 30 (33.3) | 0.183 |
Leucocyturia | 23 (14.7) | 10 (12.5) | 13 (17.1) | 0.417 | 1 (7.7) | 3 (15.0) | 3 (9.4) | 16 (17.8) | 0.594 |
Glycosuria | 10 (6.4) | 5 (6.3) | 5 (6.6) | 0.933 | 0 (0.0) | 1 (5.0) | 2 (6.3) | 7 (7.8) | 0.746 |
Lipid profile, Mean ± SD | |||||||||
Total cholesterol (g/l) | 1.8 ± 0.6 | 1.7 ± 0.5 | 2.0 ± 0.7 | 0.109 | 1.7 ± 0.3 | 1.9 ± 0.5 | 2.1 ± 0.7 | 1.8 ± 0.6 | 0.551 |
LDLc cholesterol (g/l) | 1.0 ± 0.6 | 1.0 ± 0.6 | 1.1 ± 0.7 | 0.668 | 0.4 ± 0.2 | 0.3 ± 0.2 | 0.5 ± 0.2 | 0.4 ± 0.2 | 0.214 |
HDLd cholesterol (g/l) | 0.4 ± 0.2 | 0.3 ± 0.1 | 0.4 ± 0.2 | 0.064 | 0.6 ± 0.2 | 1.0 ± 0.1 | 1.1 ± 0.7 | 1.0 ± 0.7 | 0.825 |
Triglycerides (g/l) | 1.8 ± 1.1 | 1.6 ± 0.8 | 2.0 ± 1.3 | 0.317 | 2.3 ± 0.2 | 1.6 ± 2.1 | 1.7 ± 0.9 | 1.9 ± 0.9 | 0.857 |
Hemoglobin (g/dl), Mean ± SD | 8.2 ± 2.3 | 8.7 ± 2.4 | 7.6 ± 1.9 |
0.002
| 9.8 ± 3.3 | 9.0 ± 2.2 | 8.5 ± 2.2 | 7.7 ± 2.0 |
0.004
|
Anemia, n = 148, n (%) | 139 (93.9) | 68 (90.7) | 71 (97.3) | 0.167 | 9 (75.0) | 18 (90.0) | 29 (93.5) | 84 (97.7) |
0.017
|
MCVe (fl), n = 107 | |||||||||
Mean ± SD | 85.5 ± 9.8 | 85.9 ± 9.4 | 85.1 ± 10.2 | 0.674 | 85.5 ± 9.8 | 85.8 ± 8.1 | 85.3 ± 7.9 | 85.4 ± 10.7 | 0.999 |
< 80 | 34 (31.8) | 17 (31.5) | 17 (32.1) | 3 (50.0) | 4 (30.8) | 6 (30.0) | 21 (30.9) | ||
> 100 | 8 (7.5) | 4 (7.4) | 4 (7.5) | 0.997 | 0 (0.0) | 0 (0.0) | 1 (5.0) | 7 (10.3) | 0.765 |
MCHf (pg), n = 100 | |||||||||
Mean ± SD | 28.1 ± 4.3 | 28.0 ± 5.0 | 28.1 ± 3.5 | 0.885 | 29.2 ± 3.6 | 28.6 ± 3.8 | 27.6 ± 3.3 | 28.3 ± 4.0 | 0.791 |
< 28 | 48 (48.0) | 22 (45.8) | 26 (50.0) | 3 (50.0) | 6 (46.2) | 11 (57.9) | 28 (45.2) | ||
> 32 | 15 (15.0) | 8 (16.7) | 7 (13.5) | 0.875 | 2 (33.3) | 2 (15.4) | 2 (10.5) | 9 (14.5) | 0.793 |
WBCg (G/l)h, n = 124 | |||||||||
Median (1st-3th quartiles) | 5.3 (4.1–7.1) | 5.3 (4.4–7.2) | 5.1 (3.9–7.1) | 0.276 | 4.9 (4.2–5.3) | 5.3 (3.8–8.8) | 5.2 (4–8) | 5.4 (4.1–7.1) | 0.843 |
< 4 | 25 (20.7) | 9 (15.0) | 16 (26.2) | 0 (0.0) | 5 (31.3) | 5 (21.7) | 15 (20.3) | ||
> 10 | 12 (9.9) | 5 (8.3) | 7 (11.5) | 0.218 | 0 (0.0) | 1 (6.3) | 1 (4.3) | 10 (13.5) | 0.314 |
Platelets (G/l), n = 121 | |||||||||
Mean ± SD | 223.4 ± 94.1 | 214.6 ± 93.0 | 232.4 ± 95.2 | 0.300 | 224.3 ± 112.5 | 213.5 ± 85.4 | 214.4 ± 91.6 | 223.6 ± 93.6 | 0.877 |
< 150 | 25 (20.7) | 16 (26.2) | 9 (15.0) | 0.267 | 2 (22.2) | 2 (11.1) | 5 (20.8) | 16 (22.5) | 0.511 |
Natremia (mmol/l), n = 111 | |||||||||
Mean ± SD | 135.0 ± 8.8 | 134.6 ± 9.1 | 135.4 ± 8.6 | 0.639 | 136.1 ± 6.5 | 134.9 ± 6.1 | 136.8 ± 10.1 | 134.3 ± 9.2 | 0.718 |
< 135 | 44 (39.6) | 23 (40.4) | 21 (38.9) | 0.571 | 5 (55.6) | 5 (38.5) | 4 (19.0) | 31 (44.9) | 0.393 |
Potassium (mmol/l), n = 109 | |||||||||
Mean ± SD | 5.3 ± 3.3 | 5.0 ± 0.98 | 4.9 ± 1.2 | 0.726 | 4.2 ± 0.5 | 4.8 ± 0.9 | 4.8 ± 0.8 | 5.1 ± 1.2 | 0.096 |
< 3.5 | 4 (3.7) | 2 (3.6) | 2 (3.7) | 0 (0.0) | 0 (0.0) | 1 (5.0) | 3 (4.3) | ||
> 5.0 | 47 (43.1) | 27 (49.1) | 20 (37.0) | 0.437 | 1 (11.1) | 6 (50.0) | 10 (50.0) | 30 (43.5) | 0.435 |
Chloremia (mmol/l), n = 101 | |||||||||
Mean ± SD | 101.7 ± 9.4 | 101.0 ± 9.7 | 102.6 ± 8.9 | 0.410 | 99.1 ± 10.3 | 103.8 ± 11.5 | 103.1 ± 7.2 | 101.3 ± 9.4 | 0.631 |
< 95 | 25 (24.8) | 14 (25.5) | 11 (23.9) | 3 (37.5) | 3 (25.0) | 3 (17.6) | 16 (24.6) | ||
> 105 | 33 (32.7) | 15 (27.3) | 18 (39.1) | 0.421 | 2 (25.0) | 6 (50.0) | 5 (29.4) | 20 (30.6) | 0.724 |
Calcemia (mg/l), n = 102 | |||||||||
Mean ± SD | 84.6 ± 13.7 | 87.5 ± 15.3 | 81.5 ± 11.1 |
0.024
| 84.6 ± 8.8 | 89.9 ± 10.5 | 87.5 ± 10.0 | 83.1 ± 15.1 | 0.413 |
< 90 | 70 (68.6) | 31 (60.8) | 39 (76.5) | 5 (62.5) | 5 (55.6) | 8 (47.1) | 52 (75.4) | ||
> 105 | 2 (2.0) | 2 (3.9) | 0 (0.0) | 0.128 | 0 (0.0) | 1 (11.1) | 0 (0.0) | 1 (1.4) | 0.102 |
Phosphoremia (mg/l), n = 89 | |||||||||
Mean ± SD | 56.6 ± 31.5 | 50.8 ± 26.4 | 62.3 ± 35.1 | 0.086 | 38.2 ± 19.3 | 36.6 ± 8.5 | 49.9 ± 28.2 | 62.1 ± 33.2 | 0.056 |
< 35 | 22 (24.7) | 12 (27.3) | 10 (22.2) | 2 (33.3) | 5 (71.4) | 5 (35.7) | 10 (16.1) | ||
> 55 | 32 (36.0) | 11 (25.0) | 21 (46.7) | 0.096 | 1 (16.7) | 0 (0.0) | 3 (21.4) | 28 (45.2) |
0.022
|
Uricemia (mg/l), n = 66 | |||||||||
Mean ± SD | 89.3 ± 32.2 | 91.7 ± 33.2 | 88.7 ± 31.4 | 0.530 | 78.1 ± 16.1 | 78.5 ± 24.2 | 88.4 ± 35.2 | 93.8 ± 34.2 | 0.509 |
> 70 | 50 (75.8) | 27 (79.4) | 23 (71.9) | 0.515 | 5 (83.3) | 6 (75.0) | 11 (73.3) | 28 (75.7) | 0.982 |
Albuminemia (g/l), n = 80 | |||||||||
Mean ± SD | 32.8 ± 11.2 | 33.5 ± 13.9 | 31.9 ± 7.5 | 0.531 | 34.0 ± 2.9 | 29.7 ± 7.2 | 37.3 ± 18.4 | 31.7 ± 9.0 | 0.294 |
< 35 | 51 (63.7) | 27 (65.9) | 24 (61.5) | 0.688 | 3 (60.0) | 6 (75.0) | 9 (56.3) | 34 (65.4) | 0.822 |
Outcome
Outcome | Total n (%) N = 156 | Male n (%) N = 80 | Female n (%) N = 76 |
P
|
---|---|---|---|---|
At referral | ||||
Dialysis | 37 (23.7) | 16 (20.0) | 21 (27.6) | 0.263 |
Vascular access | ||||
CVCa | 34 (91.9) | 16 (100.0) | 18 (85.7) | |
AVFb | 3 (8.1) | 0 (0.0) | 3 (14.3) | 0.243 |
Dialysis indication, n = 37 | ||||
Uremic syndrome | 30 (81.1) | 12 (75.0) | 18 (85.7) | 0.437 |
Acute pulmonary edema | 6 (16.2) | 3 (18.8) | 3 (14.3) | > 0.999 |
Severe hyperkalemia | 4 (10.8) | 212.5) | 2 (9.5) | > 0.999 |
Uremic encephalopathy | 3 (8.1) | 1 (6.3) | 2 (9.5) | > 0.999 |
At 1 year | ||||
Unknown | ||||
Transfer to another hospital | 5 (3.2) | 3 (3.8) | 2 (2.6) | 0.692 |
Lost to follow up | 64 (41.0) | 34 (42.5) | 30 (39.5) | 0.701 |
Known, n = 87 | ||||
Deceased | 43 (49.4) | 21 (48.8) | 22 (50.0) | 0.914 |
On chronic dialysis | 25 (28.7) | 12 (27.9) | 13 (29.5) | 0.866 |
Alive and not on dialysis | 19 (21.8) | 10 (23.3) | 9 (20.5) | 0.752 |
CD4c, n = 21 | 380 (265–598.5) | 353.5 (251.5–588.8) | 476 (271.5–685) | 0.804 |
Outcome | Stage of kidney disease |
P
| |||
---|---|---|---|---|---|
G3a N = 13 | G3b N = 20 | G4 N = 32 | G5 N = 91 | ||
Unknown | |||||
Transfer to another hospital | 0 (0) | 0 (0) | 1 (3.1) | 4 (4.4) | 0.680 |
Lost to follow up | 8 (61.5) | 14 (70.0) | 20 (62.5) | 22 (24.2) |
< 0.001
|
Known | n = 5 | n = 6 | n = 11 | n = 65 | |
Deceased | 2 (40.0) | 3 (50.0) | 4 (36.4) | 34 (52.3) | 0.766 |
On chronic dialysis | 1 (20.0) | 1 (16.7) | 2 (18.2) | 21 (32.3) | 0.656 |
Alive and not on dialysis | 2 (40.0) | 2 (33.3) | 5 (45.5) | 10 (15.4) | 0.085 |
Variable | Basic models | Final models | ||
---|---|---|---|---|
HRa (95% CIb) |
p
| HRa (95% CIb) |
p
| |
Age (per years increase) | 0.99 (0.96–1.02) | 0.452 | 1.00 (0.97–1.02) | 0.742 |
Gender (female vs male) | 1.02 (0.55–1.89) | 0.963 | 1.15 (0.61–2.16) | 0.663 |
Unemployed | 1.37 (0.68–2.73) | 0.380 | ||
Hypertension | 1.58 (0.84–2.96) | 0.156 | ||
Diabetes | 0.56 (0.23–1.40) | 0.216 | ||
Hepatitis B | 0.61 (0.08–4.53) | 0.632 | ||
Hepatitis C | 1.43 (0.58–3.55) | 0.442 | ||
On cARTc | 0.45 (0.23–0.89) |
0.021
| 0.45 (0.23–0.89) |
0.021
|
CD4 count (cells/mm3) | 1.00 (0.99–1.00) | 0.823 | ||
Stage of CKD at arrival | ||||
G3 | 1 (reference) | |||
G4 | 0.45 (0.10–2.03) | 0.299 | ||
G5 | 1.16 (0.42–3.17) | 0.780 | ||
Hemoglobin level (per g/dl) | 0.91 (0.79–1.05) | 0.201 | ||
Calcium level (per 10 mg/l) | 0.81 (0.59–1.10) | 0.178 | ||
Creatinine level (per 10 mg/l) | 1.01 (0.97–1.05) | 0.606 |