免疫重建不良的人类免疫缺陷病毒感染/艾滋病患者肾损伤的发生率及其危险因素

Incidence and risk factors of renal injury in human immunodeficiency virus infection/acquired immunodeficiency syndrome patients with poor immune reconstitution

目的探讨免疫重建不良的人类免疫缺陷病毒(HIV)感染/艾滋病患者肾损伤的发生率及其相关危险因素。方法纳入2021年1至12月在杭州市西溪医院感染二科门诊就诊的免疫重建不良的HIV感染/艾滋病患者, 收集患者的临床资料和实验室检查结果。采用logistic回归分析相关危险因素。结果 303例HIV感染/艾滋病免疫重建不良患者中, 59例(19.5%)发生肾损伤。logistic回归分析显示, 合并高血压[比值比(OR)=0.200, 95%可信区间(95%CI) 0.065~0.618, P=0.005]、服用替诺福韦(OR=0.275, 95%CI 0.130~0.580, P=0.001)、低蛋白血症(OR=1.045, 95%CI 1.006~1.086,P=0.022)、低CD4+T淋巴细胞计数(OR=1.009, 95%CI 1.003~1.014, P=0.001)是其发生肾损伤的危险因素。结论免疫重建不良的HIV感染/艾滋病患者合并肾损伤的发生率高, 合并高血压、服用替诺福韦、低蛋白血症、低CD4+T淋巴细胞计数是患者发生肾损伤的危险因素。

Objective To investigate the incidence and risk factors of renal injury in human immunodeficiency virus(HIV)infection/acquired immunodeficiency syndrome(AIDS)patients with poor immune reconstitution.Methods The HIV infection/AIDS patients with poor immune reconstitution who were visited Second Department of Infection of Hangzhou Xixi Hospital from January to December 2021 were enrolled.The clinical data and laboratory examinations of the patients were collected,and the relevant risk factors were analyzed by logistic regression.Results Among 303 HIV infection/AIDS patients with poor immune reconstitution,59(19.5%)patients had renal injury.Logistic regression analysis showed that hypertension(odds ratio(OR)=0.200,95%confidence interval(95%CI)0.065 to 0.618,P=0.005),taking tenofovir(OR=0.275,95%CI 0.130 to 0.580,P=0.001),hypoproteinemia(OR=1.045,95%CI 1.006 to 1.086,P=0.022),and low CD4+T lymphocytes level(OR=1.009,95%CI 1.003 to 1.014,P=0.001)were risk factors for renal injury.Conclusions The incidence of renal injury in HIV infection/AIDS patients with poor immune reconstitution is high.Hypertension,taking tenofovir,hypoproteinemia,and low CD4+T lymphocytes level are risk factors for renal injury in patients.