What is the prevalence of HIV-related renal disorders?

Updated: May 09, 2018
  • Author: Moro O Salifu, MD, MPH, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Answer

Acute kidney injury (AKI) is more common in HIV-infected persons than in the general population. Although HIV-asociated AKI has become less common since the introduction of potent antiretroviral therapy, the incidence remains substantial, and the trend is toward more severe AKI and increased mortality risk. [1]  

The prevalence of HIV-associated chronic kidney disease (CKD) varies geographically and depends on the definition of CKD used. In North America and Europe, HIV-associated CKD prevalence ranges from 4.7%–9.7% when CKD is defined as estimated glomerular filtration rate (eGFR) 2</sup>. The prevalence of CKD in the United States increases to 15.5% with a change in definition to include a reduced eGFR and/or proteinuria. [10]  

Screening studies defining persistent proteinuria as an indicator of CKD revealed prevalence rates of 27% in India, 12.3% in Iran, and 5.6% in Brazil. In Africa, HIV-associated the prevalence of renal disease is widely variable: 38% in Nigeria, 33.5% in Zambia, 26% in Cote d’Ivoire, 20% in Uganda, 11.5% in Kenya, and 5.5%–6% in South Africa. [10]  

HIV-positive individuals now comprise 1.5% of the United States end-stage renal disease (ESRD) population, and the prevalence of ESRD in this population continues to rise. [11]  There is a twofold to 20-fold greater risk of ESRD compared with the general population, with incidence rates in the US and Europe of 3 to 10 per 1,000 person-years in HIV-positive individuals versus 0.5 per 1,000 person-years in HIV-negative individuals. [10]  There is also a significant racial disparity in the burden of ESRD, with a six times higher risk borne by individuals of African origin. [11]


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