• 1 Kirby Institute, UNSW, Sydney, Australia
  • 2 Chennai Antiviral Research and Treatment Clinical Research Site (CART CRS), VHS-Infectious Diseases Medical Centre, VHS, Chennai, India
  • 3 Institute of Infectious Diseases, Pune, India
  • 4 Tan Tock Seng Hospital, Singapore
  • 5 National Center for HIV/AIDS, Dermatology & STDs, Phnom Penh, Cambodia
  • 6 Queen Elizabeth Hospital, Hong Kong SAR
  • 7 National Hospital for Tropical Diseases, Hanoi, Vietnam
  • 8 Taipei Veterans General Hospital, Taipei, Taiwan
  • 9 Bach Mai Hospital, Hanoi, Vietnam
  • 10 Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
  • 11 Research Institute for Health Sciences, Chiang Mai, Thailand
  • 12 Faculty of Medicine Udayana University & Sanglah Hospital, Bali, Indonesia
  • 13 Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • 14 University Malaya Medical Centre, Kuala Lumpur, Malaysia
  • 15 Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand
  • 16 Beijing Ditan Hospital, Capital Medical University, Beijing, China
  • 17 Hospital Sungai Buloh, Sungai Buloh, Malaysia
  • 18 National Center for Global Health and Medicine, Tokyo, Japan
  • 19 BJ Government Medical College and Sassoon General Hospital, Pune, India
  • 20 Research Institute for Tropical Medicine, Muntinlupa City, Philippines
  • 21 Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
  • 22 TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand
  • 23 HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
PMID: 32740369 DOI: 10.1097/QAI.0000000000002464


BACKGROUND: We validated the Data collection on Adverse events of anti-HIV Drugs (D:A:D) full- and short-risk score models for CKD in the Asian HIV cohorts.

SETTINGS: A validation study among people living with HIV(PLHIV) aged ≥18 years among the cohorts in the Asia-Pacific region.

METHODS: PLHIV with baseline eGFR>60 mL/min/1.73m were included for validation of the D:A:D CKD full version and the short version without cardiovascular risk factors. Those with <3 eGFR measurements from baseline or previous exposure to potentially nephrotoxic antiretrovirals were excluded. Kaplan-Meier methods were used to estimate the probability of CKD development. Area Under the Receiver Operating Characteristics (AUROC) was also used to validate the risk score.

RESULTS: We included 5,701 participants in full model(median 8.1 [IQR 4.8-10.9] years follow-up) and 9,791 in short model validation(median 4.9 [IQR 2.5-7.3] years follow-up). The crude incidence rate of CKD was 8.1 (95%CI 7.3-8.9) per 1,000 person-years(PYS) in the full model cohort and 10.5 (95%CI 9.6-11.4) per 1,000 PYS in the short model cohort. The progression rates for CKD at 10 years in the full model cohort were 2.7%, 8.9% and 26.1% for low-, medium- and high-risk groups, and 3.5%, 11.7% and 32.4% in the short model cohort. The AUROC for the full and short risk score was 0.81 (95%CI 0.79-0.83) and 0.83 (95%CI 0.81-0.85), respectively.

CONCLUSION: The D:A:D CKD full- and short-risk score performed well in predicting CKD events among Asian PLHIV. These risk prediction models may be useful to assist clinicians in identifying individuals at high risk of developing CKD.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.