Dialysis and renal transplantation in HIV-infected patients: A European survey

Objectives: To determine prevalence and characteristics of endstage renal diseases (ESRD) [dialysis and renal transplantation (RT)] among European HIV-infected patients. Methods: Cross-sectional multicenter survey of EuroSIDA clinics during 2008. Results: Prevalence of ESRD was 0.5%. Of 122 patients with ESRD 96 were on dialysis and 26 had received a RT.Median age was 47 years, 73%were males and 43% were black.Median duration of HIVinfection was 11 years. Thirty-three percent had prior AIDS; 91% were receiving antiretrovirals; and 88%had undetectable viral load. Median CD4+T-cell count was 341 cells per cubic millimetre; 20.5% had hepatitis C coinfection. Most frequent causes of ESRD were HIV-associated nephropathy (46%) and other glomerulonephritis (28%). Hemodialysis (93%) was the most common dialysis modality; 34% of patients were on the RT waiting list. A poor HIV control was the reason for exclusion from RT waiting list in 22.4% of cases. All the RT recipients were all alive at the time of the survey. Acute rejection was reported in 8 patients (30%). Functioning graft was present in 21 (80%). Conclusions: This is the first multinational cross-sectional study of ESRD among European HIV population. Low prevalence of ESRD was found. Two-thirds of patients were excluded from RT for non- HIV/AIDS-related pathologies. Most patients had a functioning graft despite a high acute rejection rate.