Racial Differences in Progression of Kidney Disease Among HIV-Infected Patients

In the U.S., HIV-infected blacks have a much higher rate of end-stage renal disease (ESRD) than do HIV-infected whites. Is this disparity due to differences in the incidence of chronic kidney disease (CKD) or to variable rates of progression once CKD has developed? Investigators at Johns Hopkins examined this question in a cohort study of 4259 HIV-infected patients. CKD was defined as a glomerular filtration rate (GFR) of <60 mL/min/1.73 m² as estimated by the MDRD (Modification of Diet in Renal Disease) equation.

A greater proportion of blacks than whites had CKD at the time of enrollment (2.1% vs. 0.3%). Of the 4185 patients without CKD at enrollment, 210 developed the disease during follow-up (incidence rate, 11.2 per 1000 person-years). …