Cavalcante MG, Parente MDSR, Gomes PEADC, Meneses GC, Silva Júnior GBD, Pires Neto RDJ, Daher EDF. Death-related factors in HIV/AIDS patients undergoing hemodialysis in an intensive care unit.
Rev Inst Med Trop Sao Paulo 2021;
63:e33. [PMID:
33909847 PMCID:
PMC8075620 DOI:
10.1590/s1678-9946202163033]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/19/2021] [Indexed: 12/25/2022] Open
Abstract
HIV-infected patients are at high risk for developing critical diseases,
including opportunistic infections (OI), with consequent admission in intensive
care units (ICU). Renal disfunctions are risk factors for death in HIV/AIDS
patients, and survival rates in patients undergoing hemodialysis are smaller
than the ones observed in the general population. In this context, this study
aimed to investigate death-related factors in HIV/AIDS patients in an intensive
care setting. This is a retrospective cross-sectional study performed through
the analysis of medical records from 271 HIV/AIDS-diagnosed patients
hospitalized in an intensive care unit of an infectious disease hospital, in
Fortaleza, Ceara State, Brazil. Patients were divided into two groups: those who
underwent dialysis during hospitalization and those who did not. Clinical and
demographic parameters that could be associated with death were evaluated.
Results indicated a prevalence of death of 19.1% (CI 95%: 14.8-24.3). The median
age of patients was 47 years, with a male predominance (71.3%). The main causes
of admission were pulmonary tuberculosis (16.9%), followed by neurotoxoplasmosis
(14.9%). In the bivariate analysis, for those that did not undergo dialysis,
age, fever, dyspnea, oliguria, disorientation, kidney injury, use of lamivudine
and efavirenz, length of hospitalization, CD4 count, WBC count, platelet count,
urea, sodium and LDH levels were the associated variables. In those who needed
dialysis, the use of stavudine, abacavir and ritonavir, and the length of
hospitalization were associated factors. Renal toxicity by the antiretroviral
agents and length of hospitalization increased the risk of death among HIV
patients under dialysis.
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