Evaluation of the Prognostic Value of Impaired Renal Function on Clinical Progression in a Large Cohort of @entity645 -Infected XXXX Seen for Care in Italy.

@entity1 @entity8 @entity101 @entity6 @entity2299 @entity470 @entity2858 @entity645 @entity204 @entity791 @entity65
Whilst @entity8 , especially mild impairment (60< @entity470 <90 ml/min), has been often described in @entity645 -infected population, its potential contribution to @entity645 evolution and risk of @entity65 ( @entity65 ) has not been clarified. Data from @entity2858 infected @entity1 enrolled in the Italian Cohort of Antiretroviral-Na  ve (Icona) Foundation Study collected between January 2000 and February 2014 with at least two creatinine values available. @entity470 (CKD-epi) and @entity8 defined using a priori cut-offs of 60 (severely impaired) and 90 ml/min/1.73m2 (mildly impaired). Characteristics of @entity1 were described after stratification in these groups and compared using chi-square test (categorical variables) or Kruskal Wallis test comparing median values. Follow-up accrued from baseline up to the date of the @entity65 or @entity791 related events or @entity204 or last available visit. Kaplan Meier curves were used to estimate the cumulative probability of occurrence of the events over time. Adjusted analysis was performed using a proportional hazards Cox regression model. We included 7,385 @entity1 , observed for a median follow-up of 43 months (inter-quartile range [IQR]: 21-93 months). Over this time, 130 cerebro-cardiovascular events (including 11 @entity204 due to @entity65 ) and 311 @entity791 -related events (including 45 @entity204 ) were observed. The rate of @entity65 events among @entity1 with @entity470 >90, 60-89, <60 ml/min, was 2.91 (95% CI 2.30-3.67), 4.63 (95% CI 3.51-6.11) and 11.9 (95% CI 6.19-22.85) per 1,000 PYFU respectively, with an unadjusted hazard ratio (HR) of 4.14 (95%CI 2.07-8.29) for @entity1 with @entity470 <60 ml/min and 1.58 (95%CI 1.10-2.27) for @entity470 60-89 compared to those with @entity470 >= 90. Of note, these estimates are adjusted for traditional cardio-vascular risk factors (e.g. smoking, @entity6 , @entity101 , @entity2299 ). Incidence of @entity791 -related events was 9.51 (95%CI 8.35-10.83), 6.04 (95%CI 4.74-7.71) and 25.0 (95%CI 15.96-39.22) per 1,000 PYFU, among @entity1 with @entity470 >90, 60-89, <60 ml/min, respectively, with an unadjusted HR of 2.49 (95%CI 1.56-3.97) for @entity1 with @entity470 <60 ml/min and 0.68 (95%CI 0.52-0.90) for @entity470 60-89. The risk of @entity791 events was significantly lower in mild @entity8 group even after adjustment for @entity645 -related characteristics. Our data confirm that @entity8 is an important risk marker for @entity65 events in the @entity645 -population; importantly, even those with mild @entity8 (90< @entity470 <60) seem to be at increased risk of cerebro-cardiovascular morbidity and mortality.
