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. 2020 Dec 1;85(4):489-497.
doi: 10.1097/QAI.0000000000002464.

Validation of the D: A: D Chronic Kidney Disease Risk Score Model Among People Living With HIV in the Asia-Pacific

Win Min Han  1   2 , Rimke Bijker  1 , Ezhilarasi Chandrasekaran  3 , Sanjay Pujari  4 , Oon Tek Ng  5 , Penh Sun Ly  6 , Man-Po Lee  7 , Kinh Van Nguyen  8 , Yu-Jiun Chan  9 , Cuong Duy Do  10 , Jun Yong Choi  11 , Romanee Chaiwarith  12 , Tuti Parwati Merati  13 , Sasisopin Kiertiburanakul  14 , Iskandar Azwa  15 , Suwimon Khusuwan  16 , Fujie Zhang  17 , Yasmin Mohamed Gani  18 , Junko Tanuma  19 , Shashikala Sangle  20 , Rossana Ditangco  21 , Evy Yunihastuti  22 , Jeremy Ross  23 , Anchalee Avihingsanon  2   24 ; IeDEA Asia-Pacific
Affiliations

Validation of the D: A: D Chronic Kidney Disease Risk Score Model Among People Living With HIV in the Asia-Pacific

Win Min Han et al. J Acquir Immune Defic Syndr. .

Abstract

Background: We validated the Data collection on Adverse events of anti-HIV Drugs (D:A:D) full-risk and short-risk score models for chronic kidney disease (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 a baseline estimated glomerular filtration rate > 60 mL/min/1.73 m were included for validation of the D:A:D CKD full version and short version without cardiovascular risk factors. Those with <3 estimated glomerular filtration rate measurements from baseline or previous exposure to potentially nephrotoxic antiretrovirals were excluded. Kaplan-Meier methods were used to estimate the probability of CKD development. The area under the receiver operating characteristics was also used to validate the risk score.

Results: We included 5701 participants in full model {median 8.1 [interquartile range (IQR) 4.8-10.9] years follow-up} and 9791 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% confidence interval (CI): 7.3 to 8.9] per 1000 person-years in the full model cohort and 10.5 (95% CI: 9.6 to 11.4) per 1000 person-years 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-risk, medium-risk, and high-risk groups, and 3.5%, 11.7%, and 32.4% in the short model cohort. The area under the receiver operating characteristics for the full-risk and short-risk score was 0.81 (95% CI: 0.79 to 0.83) and 0.83 (95% CI: 0.81 to 0.85), respectively.

Conclusion: The D:A:D CKD full-risk 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.

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Conflict of interest statement

Conflict of interest

The authors declare no conflict of interests related to this work.

Figures

Figure 1.
Figure 1.
Kaplan-Meier progression to CKD among TAHOD (full risk score) and TAHOD-LITE (short risk score)
Figure 1.
Figure 1.
Kaplan-Meier progression to CKD among TAHOD (full risk score) and TAHOD-LITE (short risk score)
Figure 2.
Figure 2.
Calibration of full and short D:A:D CKD risk score models among TAHOD (full risk score) and TAHOD-LITE (short- risk score)
Figure 2.
Figure 2.
Calibration of full and short D:A:D CKD risk score models among TAHOD (full risk score) and TAHOD-LITE (short- risk score)
See this image and copyright information in PMC

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