The Anaemia and Thrombocytopenia Level may Predict Lower eGFR and Progressive Renal Impairment in ARV-Treated HIV-Infected Patients
Magdalena Dabrowska
Abstract:
Background. Renal disorders have become one of the most important co-morbidities in management of HIV-infected patients. Anaemia in patients with CKD, the most often, develops in response to erythropoietin deficiency.
Methods. We analyzed 744 serum creatinine and complete blood count (CBC) analysis from 218 HIV-infected individuals (184 male, 34 female, mean age 39.5 years, 131 on cART) over a 3-year period. GFR was estimated using the abbreviated Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations.
Results. 24.8% (54/218) of studied patients fulfilled the WHO criteria of anaemia. In patients with cART, eGFR was positively correlated with red blood cells (RBC) and platelets count, and negatively correlated with mean corpuscular volume (MCV) (p<0.05) and independent from gender and used type of eGFR formula. In logistic regression analysis, lower eGFR strongly predicted lower RBC and platelets levels (p<0.0001; OR 0.08, 95%CI: 0.03, 0.22 and OR 0.99, 95%CI: 0.987, 0.993, respectively). There was no correlation between CBC and eGFR in naïve HIV-infected subjects and in patients without anaemia.
Conclusions. eGFR in all HIV-infected subjects with anaemia, especially on treatment with nephrotoxic drugs and concomitant thrombocytopenia, should be monitored more frequently then standardly recommended every 3-6 months.
