Acute kidney injury in AIDS: frequency, RIFLE classification and outcome

ABSTRACT

The objective of the present study was to evaluate the characteristics of acute kidney injury (AKI) in AIDS patients and the value of RIFLE classification for predicting outcome. The study was conducted on AIDS patients admitted to an infectious diseases hospital inBrazil. The patients with AKI were classified according to the RIFLE classification: R (risk), I (injury), F (failure), L (loss), and E (end-stage renal disease). Univariate and multivariate analyses were used to evaluate the factors associated with AKI. A total of 532 patients with a mean age of 35 ± 8.5 years were included in this study. AKI was observed in 37 percent of the cases. Patients were classified as "R" (18 percent), "I" (7.7 percent) and "F" (11 percent). Independent risk factors for AKI were thrombocytopenia (OR = 2.9, 95 percentCI = 1.5-5.6, P < 0.001) and elevation of aspartate aminotransferase (AST) (OR = 3.5, 95 percentCI = 1.8-6.6, P < 0.001). General mortality was 25.7 percent and was higher among patients with AKI (40.2 vs17 percent, P < 0.001). AKI was associated with death and mortality increased according to RIFLE classification - "R" (OR 2.4), "I" (OR 3.0) and "F" (OR 5.1), P < 0.001. AKI is a frequent complication in AIDS patients, which is associated with increased mortality. RIFLE classification is an important indicator of poor outcome for AIDS patients.