Acute kidney injury and other factors associated with mortality in hiv-infected patients
SUMMARY OBJECTIVE: HIV-related mortality is still high, especially in developed countries. The aim of this study is to investigate factors associated to death in HIV-infected patients. METHODS: This is a cross-sectional study with all HIV adult patients admitted to a tertiary infectious diseases h...
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doaj-ba6cd9147bb54271a732ad8bc339f4a12020-11-25T00:07:26ZengAssociação Médica BrasileiraRevista da Associação Médica Brasileira1806-928264650951710.1590/1806-9282.64.06.509S0104-42302018000600509Acute kidney injury and other factors associated with mortality in hiv-infected patientsGeraldo Bezerra da Silva JuniorSérgio Luiz Arruda Parente FilhoDouglas de Sousa SoaresRodrigo da Nóbrega de AlencarTiago Tomaz Teles PeixotoIsadora Sales NogueiraAntônio Mendes Ponte de Oliveira FilhoFernanda Holanda MenezesMalena Gadelha CavalcanteRoberto da Justa Pires NetoElizabeth de Francesco DaherSUMMARY OBJECTIVE: HIV-related mortality is still high, especially in developed countries. The aim of this study is to investigate factors associated to death in HIV-infected patients. METHODS: This is a cross-sectional study with all HIV adult patients admitted to a tertiary infectious diseases hospital in Fortaleza, Northeast Brazil, from January 2013 to December 2014. Patients were divided into two groups: survivors and non-survivors. Demo-graphical, clinical and laboratory data were compared and a logistic regression was performed in order to investigate risk factors for death. P values ≤0.05 were considered statistically significant. RESULTS: A total of 200 patients with mean age of 39 years were including in the study, 69.5% males. Fifteen patients (7.5%) died. Non-survivors presented a higher percentage of males (93.3 vs. 67.3%, p = 0.037). Non-survivors presented AKI (73.3 vs. 10.3%, p < 0.001), liver dysfunction (33.3 vs. 11.5, p = 0.031), dyspnea (73.3 vs. 33.0%, p = 0.002) and disorientation (33.3 vs. 12.4%, p = 0.025) more frequently. Non-survivors also had higher levels of urea (73.8 ± 52.7vs. 36.1 ± 29.1 mg/dL, p < 0.001), creatinine (1.98 ± 1.65 vs. 1.05 ± 1.07 mg/dL, p < 0.001), aspartate aminotransferase (130.8 vs. 84.8 U/L, p = 0.03), alanine aminotransferase (115.6 vs. 85.4 U/L, p = 0.045) and lactate dehydrogenase (LDH) (1208 vs. 608 U/L, p = 0.012), as well as lower levels of bicarbonate (18.0 ± 4.7 vs. 21.6 ± 4.6 mEq/L, p = 0.016) and PCO2 (27.8 ± 7.7 vs. 33.0 ± 9.3 mmHg, p = 0.05). In multivariate analysis, disorientation (p = 0.035, OR = 5.523, 95%CI = 1.130 – 26.998), dyspnoea (p = 0.046, OR = 4.064, 95%CI = 1.028 – 16.073), AKI (p < 0.001, OR = 18.045, 95%CI = 4.308 – 75.596) and disseminated histoplasmosis (p = 0.016, OR = 12.696, 95%CI = 1.618 – 99.646) and LDH > 1000 U/L (p = 0.038, OR = 4.854, 95%CI = 1.093 – 21.739) were risk factors for death.]CONCLUSION: AKI and disseminated histoplasmosis (DH) were the main risk factors for death in the studied population. Neurologic and respiratory impairment as well as higher levels of LDH also increased mortality in HIV-infected patients.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302018000600509&lng=en&tlng=enHIVMortalityRisk factorsHistoplasmosisLactate dehydrogenase |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Geraldo Bezerra da Silva Junior Sérgio Luiz Arruda Parente Filho Douglas de Sousa Soares Rodrigo da Nóbrega de Alencar Tiago Tomaz Teles Peixoto Isadora Sales Nogueira Antônio Mendes Ponte de Oliveira Filho Fernanda Holanda Menezes Malena Gadelha Cavalcante Roberto da Justa Pires Neto Elizabeth de Francesco Daher |
spellingShingle |
Geraldo Bezerra da Silva Junior Sérgio Luiz Arruda Parente Filho Douglas de Sousa Soares Rodrigo da Nóbrega de Alencar Tiago Tomaz Teles Peixoto Isadora Sales Nogueira Antônio Mendes Ponte de Oliveira Filho Fernanda Holanda Menezes Malena Gadelha Cavalcante Roberto da Justa Pires Neto Elizabeth de Francesco Daher Acute kidney injury and other factors associated with mortality in hiv-infected patients Revista da Associação Médica Brasileira HIV Mortality Risk factors Histoplasmosis Lactate dehydrogenase |
author_facet |
Geraldo Bezerra da Silva Junior Sérgio Luiz Arruda Parente Filho Douglas de Sousa Soares Rodrigo da Nóbrega de Alencar Tiago Tomaz Teles Peixoto Isadora Sales Nogueira Antônio Mendes Ponte de Oliveira Filho Fernanda Holanda Menezes Malena Gadelha Cavalcante Roberto da Justa Pires Neto Elizabeth de Francesco Daher |
author_sort |
Geraldo Bezerra da Silva Junior |
title |
Acute kidney injury and other factors associated with mortality in hiv-infected patients |
title_short |
Acute kidney injury and other factors associated with mortality in hiv-infected patients |
title_full |
Acute kidney injury and other factors associated with mortality in hiv-infected patients |
title_fullStr |
Acute kidney injury and other factors associated with mortality in hiv-infected patients |
title_full_unstemmed |
Acute kidney injury and other factors associated with mortality in hiv-infected patients |
title_sort |
acute kidney injury and other factors associated with mortality in hiv-infected patients |
publisher |
Associação Médica Brasileira |
series |
Revista da Associação Médica Brasileira |
issn |
1806-9282 |
description |
SUMMARY OBJECTIVE: HIV-related mortality is still high, especially in developed countries. The aim of this study is to investigate factors associated to death in HIV-infected patients. METHODS: This is a cross-sectional study with all HIV adult patients admitted to a tertiary infectious diseases hospital in Fortaleza, Northeast Brazil, from January 2013 to December 2014. Patients were divided into two groups: survivors and non-survivors. Demo-graphical, clinical and laboratory data were compared and a logistic regression was performed in order to investigate risk factors for death. P values ≤0.05 were considered statistically significant. RESULTS: A total of 200 patients with mean age of 39 years were including in the study, 69.5% males. Fifteen patients (7.5%) died. Non-survivors presented a higher percentage of males (93.3 vs. 67.3%, p = 0.037). Non-survivors presented AKI (73.3 vs. 10.3%, p < 0.001), liver dysfunction (33.3 vs. 11.5, p = 0.031), dyspnea (73.3 vs. 33.0%, p = 0.002) and disorientation (33.3 vs. 12.4%, p = 0.025) more frequently. Non-survivors also had higher levels of urea (73.8 ± 52.7vs. 36.1 ± 29.1 mg/dL, p < 0.001), creatinine (1.98 ± 1.65 vs. 1.05 ± 1.07 mg/dL, p < 0.001), aspartate aminotransferase (130.8 vs. 84.8 U/L, p = 0.03), alanine aminotransferase (115.6 vs. 85.4 U/L, p = 0.045) and lactate dehydrogenase (LDH) (1208 vs. 608 U/L, p = 0.012), as well as lower levels of bicarbonate (18.0 ± 4.7 vs. 21.6 ± 4.6 mEq/L, p = 0.016) and PCO2 (27.8 ± 7.7 vs. 33.0 ± 9.3 mmHg, p = 0.05). In multivariate analysis, disorientation (p = 0.035, OR = 5.523, 95%CI = 1.130 – 26.998), dyspnoea (p = 0.046, OR = 4.064, 95%CI = 1.028 – 16.073), AKI (p < 0.001, OR = 18.045, 95%CI = 4.308 – 75.596) and disseminated histoplasmosis (p = 0.016, OR = 12.696, 95%CI = 1.618 – 99.646) and LDH > 1000 U/L (p = 0.038, OR = 4.854, 95%CI = 1.093 – 21.739) were risk factors for death.]CONCLUSION: AKI and disseminated histoplasmosis (DH) were the main risk factors for death in the studied population. Neurologic and respiratory impairment as well as higher levels of LDH also increased mortality in HIV-infected patients. |
topic |
HIV Mortality Risk factors Histoplasmosis Lactate dehydrogenase |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302018000600509&lng=en&tlng=en |
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