Original Research

Survival outcomes of HIV-positive adults on peritoneal dialysis at Helen Joseph renal unit

Kagisho L. Thomas, Malcolm Davies
Southern African Journal of HIV Medicine | Vol 24, No 1 | a1471 | DOI: https://doi.org/10.4102/sajhivmed.v24i1.1471 | © 2023 Kagisho L. Thomas, Malcolm Davies | This work is licensed under CC Attribution 4.0
Submitted: 16 November 2022 | Published: 10 May 2023

About the author(s)

Kagisho L. Thomas, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Malcolm Davies, Renal Department, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Abstract

Background: HIV is a risk factor for the development of chronic kidney disease. People with chronic kidney disease in the state sector are likely to be prescribed continuous ambulatory peritoneal dialysis (CAPD). Previous studies have raised concern about the safety of CAPD in people living with HIV (PLWH) compared to HIV-negative patients.

Objectives: To compare the risk of peritonitis, and modality and patient survival by HIV status in patients receiving CAPD at Helen Joseph Hospital.

Method: A retrospective study of patients receiving CAPD between 01 January 2007 and 31 December 2017 was undertaken. Five-year patient and modality survival were modelled for PLWH and HIV-negative subgroups and analysed using the log-rank test; the effect of CD4 count, HIV viral load, and duration of antiretroviral therapy on these parameters in PLWH were additionally modelled using the Cox Proportional Hazards technique.

Results: Eighty-four patients, comprising of 21 PLWH and 63 HIV-negative patients, were analysed. No difference was observed in the proportion of patients who had at least one episode of peritonitis between PLWH (61.2%) and HIV-negative patients (63.5%) (P = 0.547). A trend towards increased risk of peritonitis due to Gram-negative organisms in PLWH was noted (odds ratio: 3.20, 95% confidence interval: 0.86–11.9, P = 0.083). No difference was observed in 5-year patient or modality survival on CAPD between PLWH (log-rank P = 0.161) and HIV-negative patients (log-rank P = 0.240).

Conclusion: People living with HIV should not be excluded from CAPD as a mode of kidney replacement therapy (KRT).


Keywords

HIV; continuous ambulatory peritoneal dialysis; chronic kidney disease; peritonitis; antiretrovirals

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