Death-related factors in HIV/AIDS patients undergoing hemodialysis in an intensive care unit.
Malena Gadelha CavalcanteMatheus de Sá Roriz ParentePedro Eduardo Andrade de Carvalho GomesGdayllon Cavalcante MenesesGeraldo Bezerra da Silva JúniorRoberto Da Justa Pires NetoElizabeth de Francesco DaherPublished in: Revista do Instituto de Medicina Tropical de Sao Paulo (2021)
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.
Keyphrases
- end stage renal disease
- hiv aids
- chronic kidney disease
- intensive care unit
- antiretroviral therapy
- peritoneal dialysis
- ejection fraction
- newly diagnosed
- patients undergoing
- hiv infected patients
- prognostic factors
- human immunodeficiency virus
- healthcare
- hiv infected
- pulmonary tuberculosis
- palliative care
- oxidative stress
- electronic health record
- hepatitis c virus
- patient reported outcomes
- acute respiratory distress syndrome
- risk factors
- extracorporeal membrane oxygenation
- free survival
- patient reported
- data analysis
- nk cells