***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Context As life expectancy improves among Human Immunodeficiency Virus ( HIV ) patients , renal and cardiovascular diseases are increasingly prevalent in this population . Renal and cardiovascular disease are mutual risk factors and are characterized by albuminuria . Underst and ing the interactions between HIV , cardiovascular risk factors and renal disease is the first step in tackling this new therapeutic frontier in HIV . Methods In a rural primary health care centre , 903 HIV-infected adult patients were r and omly selected and data on HIV-infection and cardiovascular risk factors were collected . Glomerular filtration rate ( eGFR ) was estimated . Albuminuria was defined as an Albumin-Creatinine-Ratio above 30 mg/g . Multivariate logistic regression analysis was used to analyse albuminuria and demographic , clinical and HIV-associated variables . Results The study population consisted of 903 HIV-infected patients , with a median age of 40 years ( Inter-Quartile Range ( IQR ) 34–48 years ) , and included 625 ( 69 % ) women . The median duration since HIV diagnosis was 26 months ( IQR 12–58 months ) and 787 ( 87 % ) received antiretroviral therapy . Thirty-six ( 4 % ) of the subjects were shown to have diabetes and 205 ( 23 % ) hypertension . In the cohort , 21 % had albuminuria and 2 % an eGFR < 60 mL/min/1.73m2 . Albuminuria was associated with hypertension ( adjusted odds ratio ( aOR ) 1.59 ; 95 % confidence interval ( CI ) 1.05–2.41 ; p<0.05 ) , total cholesterol ( aOR 1.31 ; 95 % CI 1.11–1.54 ; p<0.05 ) , eGFR ( aOR 0.98 ; 95 % CI 0.97–0.99 ; p<0.001 ) and detectable viral load ( aOR 2.74 ; 95 % CI 1.56–4.79 ; p<0.001 ) . Hypertension was undertreated : 78 % were not receiving treatment , while another 11 % were inadequately treated . No patients were receiving lipid-lowering medication . Conclusion Glomerular filtration rate was well conserved , while albuminuria was common amongst HIV-infected patients in rural South Africa . Both cardiovascular and HIV-specific variables were associated with albuminuria . Improved cardiovascular risk prevention as well as adequate virus suppression might be the key to escape the vicious circle of renal failure and cardiovascular disease and improve the long-term prognosis of HIV-infected patients Aim : To identify whether the more recently developed equation for estimated glomerular filtration rate ( eGFR ) [ Chronic Kidney Disease Epidemiology Collaboration ( CKD-EPI ) ] is more closely associated with end-organ changes than previous equations in a group of black African descent . Methods : In 1221 r and omly recruited participants of black African ancestry in South Africa , we evaluated serum creatinine concentrations , echocardiographic left ventricular mass index ( n = 833 ) , carotid-femoral ( aortic ) pulse wave velocity ( PWV ) ( n = 1053 ) and carotid intima – media thickness ( n = 633 ) . We calculated eGFR from the Jelliffe , five Cockcroft – Gault , Salazar – Corcoran , Modification of Diet in Renal Disease ( MDRD ) and CKD-EPI equations . Results : After multivariate adjustments , eGFR calculated from all formulae was inversely associated with left ventricular mass index ( P < 0.0001 ) and PWV ( P < 0.05 to < 0.001 ) , but not with carotid intima – media thickness ( P > 0.08 ) . However , although eGFR determined from all equations except Cockcroft – Gault lean body weight or adjusted body weight was independently associated with left ventricular hypertrophy ( n = 390 of 833 ) , CKD-EPI-derived eGFR , but not eGFR determined from alternative equations , was independently associated with an increased PWV ( n = 88 of 1053 ) . eGFR derived from the CKD-EPI and MDRD equations showed a better performance ( area under the receiver operator characteristic curve ) for the detection of left ventricular hypertrophy ( P < 0.0005 ) than eGFR determined from alternative equations . Conclusions : In black Africans , eGFR derived from the CKD-EPI equation is better at detecting end-organ measures than eGFR derived from either the MDRD or alternative equations . To enhance risk prediction in black African communities , eGFR calculated from the CKD-EPI equation may be preferred to other equations Background and Objectives There have been few large population -based studies of the association between rheumatoid arthritis ( RA ) and chronic kidney disease ( CKD ) and glomerulonephritis . This nationwide cohort study investigated the risks of developing CKD and glomerulonephritis in patients with RA , and the associated risks for cardiovascular complications . Methods From the Taiwan National Health Insurance Research Data base , we identified a study cohort of 12,579 patients with RA and r and omly selected 37,737 subjects without RA as a control cohort . Each subject was individually followed for up for 5 years , and the risk of CKD was analyzed using Cox proportional hazards regression models . Results During the follow-up period , after adjusting for traditional cardiovascular risk factors RA was independently associated with a significantly increased risk of CKD ( adjusted hazard ratio [ aHR ] 1.31 ; 95 % confidence interval [ CI ] 1.23–1.40 ) and glomerulonephritis ( aHR 1.55 ; 95 % CI 1.37–1.76 ) . Increased risk of CKD was also associated with the use of non-steroidal anti-inflammatory drugs , cyclosporine , glucocorticoids , mycophenolate mofetil , and cyclophosphamide .  Patients with comorbidities had even greater increased risk of CKD . Moreover , RA patients with concurrent CKD had significantly higher likelihood of developing ischemic heart disease and stroke . Conclusions RA patients had higher risk of developing CKD and glomerulonephritis , independent of traditional cardiovascular risk factors . Their increased risk of CKD may be attributed to glomerulonephritis , chronic inflammation , comorbidities , and renal toxicity of antirheumatic drugs . Careful monitoring of renal function in RA patients and tight control of their comorbid diseases and cardiovascular risk factors are warranted Background In the United States , HIV-related kidney disease disproportionately affects individuals of African descent ; however , there are few estimates of kidney disease prevalence in Africa . We evaluated the prevalence of kidney disease among HIV-infected and uninfected Rw and an women . Methods The Rw and an Women 's Interassociation Study and Assessment prospect ively enrolled 936 women . Associations with estimated glomerular filtration rate (eGFR)<60 mL/min/1.73 m2 and proteinuria were assessed in separate logistic regression models . Results Among 891 non-pregnant women with available data , 2.4 % had an eGFR<60 mL/min/1.73 m2 ( calculated by the Modification of Diet in Renal Disease equation , MDRD eGFR ) and 8.7 % had proteinuria ≥1 + . The prevalence of decreased eGFR varied markedly depending on the estimating method used , with the highest prevalence by Cockcroft-Gault . Regardless of the method used to estimate GFR , the proportion with decreased eGFR or proteinuria did not differ significantly between HIV-infected and -uninfected women in unadjusted analysis . After adjusting for age and blood pressure , HIV infection was associated with significantly higher odds of decreased MDRD eGFR but not proteinuria . Conclusion In a well-characterized cohort of Rw and an women , HIV infection was associated with decreased MDRD eGFR . The prevalence of decreased eGFR among HIV-infected women in our study was lower than that previously reported in African-Americans and in other Central and East African HIV population s , although there was substantial variability depending on the equation used to estimate GFR . Future studies are needed to optimize GFR estimates and to determine the impact of antiretroviral therapy on kidney disease in this population The objective is to investigate the accrual rate and risk factors of chronic kidney disease ( CKD ) in an inception cohort of patients with systemic lupus erythematosus ( SLE ) followed at a single tertiary center . A prospect ively collected data base of 256 consecutive patients with SLE followed over a 25-year period was systematic ally interrogated for demographic , disease manifestations , co-morbidities , and outcome . St and ardized SLE activity and damage scores were determined for the first and last study visits , and estimated glomerular filtration rate ( eGFR ; MDRD formula ) was calculated at the time of diagnosis and at each year of the follow-up . CKD was defined as eGFR < 60 ml/min/1.73 m2 . Results were analyzed with univariate and multivariate models and Kaplan-Meier curves , as appropriate . The cohort was predominantly female ( 90 % ) and Jewish ( 91.1 % ) . Mean age at diagnosis was 38 ± 15.5 years , mean SLE activity score 6.4 ± 3.8 , mean disease duration 8.8 ± 6.6 years , and mean damage score 0.2 ± 0.6 . Seventy-five patients ( 30.8 % ) were diagnosed with American College of Rheumatology (ACR)-defined lupus renal disease during the study period . There was a progressive decrease in eGFR over time . The prevalence of CKD was 46.7 % in patients with ACR-defined renal lupus disease and 16.4 % in those without . The hazards ratio for CKD was significantly higher in patients with lupus nephritis ( LN ) than without ( p < 0.001 ) . Earlier CKD was positively associated with hypertension ( p = 0.01 ) , older age at diagnosis ( p = 0.01 ) , and LN ( p < 0.001 ) , and negatively associated  with  hydroxychloroquine treatment ( p < 0.001 ) . The prevalence of CKD increases cumulatively in patients with SLE , also in those without overt lupus renal disease . Lupus renal disease poses a significant hazard for earlier development of CKD , and hypertension is a major risk factor for patients with and without nephritis . Antimalarial treatment is associated with renal preservation only in patients with lupus nephritis BACKGROUND We sought to investigate renal function in previously untreated symptomatic human immunodeficiency virus (HIV)-infected adults with CD4(+ ) cell counts of < 200 cells/mm(3 ) who were undergoing antiretroviral therapy ( ART ) in Africa . METHODS The study was an observational analysis within a r and omized trial of ART management strategies that included 3316 participants with baseline serum creatinine levels of < or = 360 micromol/L. Creatinine levels were measured before ART initiation , at weeks 4 and 12 of therapy , and every 12 weeks thereafter . We calculated estimated glomerular filtration rate ( eGFR ) using the Cockcroft-Gault formula . We analyzed the incidence of severely decreased eGFR ( < 30 mL/min/1.73 m(2 ) ) and changes in eGFR to 96 weeks , considering demographic data , type of ART , and baseline biochemical and hematological characteristics as predictors , using r and om-effects models . RESULTS Sixty-five percent of the participants were women . Median values at baseline were as follows : age , 37 years ; weight , 57 kg ; CD4(+ ) cell count , 86 cells/mm(3 ) ; and eGFR , 89 mL/min/1.73 m(2 ) . Of the participants , 1492 ( 45 % ) had mild ( > or = 60 but < 90 mL/min/1.73 m(2 ) ) and 237 ( 7 % ) had moderate ( > or = 30 but < 60 mL/min/1.73 m(2 ) ) impairments in eGFR . First-line ART regimens included zidovudine-lamivudine plus tenofovir disoproxil fumarate ( for 74 % of patients ) , nevirapine ( 16 % ) , and abacavir ( 9 % ) ( mostly nonr and omized allocation ) . After ART initiation , the median eGFR was 89 - 91 mL/min/1.73 m(2 ) for the period from week 4 through week 96 . Fifty-two participants ( 1.6 % ) developed severe reductions in eGFR by week 96 ; there was no statistically significant difference between these patients and others with respect to first-line ART regimen received ( P = .94 ) . Lower baseline eGFR or hemoglobin level , lower body mass index , younger age , higher baseline CD4(+ ) cell count , and female sex were associated with greater increases in eGFR over baseline , with small but statistically significant differences between regimens ( P < 
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Conclusion In Africa , CKD is a public health problem , mainly attributed to high-risk conditions as hypertension and diabetes .