Validation of the D:A:D Chronic Kidney Disease Risk Score Model among People Living with HIV in the Asia-Pacific

Win Min Han, Rimke Bijker, Ezhilarasi Chandrasekaran, Sanjay Pujari, Oon Tek Ng, Penh Sun Ly, Man Po Lee, Kinh Van Nguyen, Yu Jiun Chan, Cuong Duy Do, Jun Yong Choi, Romanee Chaiwarith, Tuti Parwati Merati, Sasisopin Kiertiburanakul, Iskandar Azwa, Suwimon Khusuwan, Fujie Zhang, Yasmin Mohamed Gani, Junko Tanuma, Shashikala SangleRossana Ditangco, Evy Yunihastuti, Jeremy Ross, Anchalee Avihingsanon

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Background:We validated the Data collection on Adverse events of anti-HIV Drugs (D:A:D) full-risk and short-risk score models for chronic kidney disease (CKD) in the Asian HIV cohorts.Settings:A validation study among people living with HIV (PLHIV) aged ≥18 years among the cohorts in the Asia-Pacific region.Methods:PLHIV with a baseline estimated glomerular filtration rate > 60 mL/min/1.73 m2were included for validation of the D:A:D CKD full version and short version without cardiovascular risk factors. Those with <3 estimated glomerular filtration rate measurements from baseline or previous exposure to potentially nephrotoxic antiretrovirals were excluded. Kaplan-Meier methods were used to estimate the probability of CKD development. The area under the receiver operating characteristics was also used to validate the risk score.Results:We included 5701 participants in full model {median 8.1 [interquartile range (IQR) 4.8-10.9] years follow-up} and 9791 in short model validation [median 4.9 (IQR 2.5-7.3) years follow-up]. The crude incidence rate of CKD was 8.1 [95% confidence interval (CI): 7.3 to 8.9] per 1000 person-years in the full model cohort and 10.5 (95% CI: 9.6 to 11.4) per 1000 person-years in the short model cohort. The progression rates for CKD at 10 years in the full model cohort were 2.7%, 8.9%, and 26.1% for low-risk, medium-risk, and high-risk groups, and 3.5%, 11.7%, and 32.4% in the short model cohort. The area under the receiver operating characteristics for the full-risk and short-risk score was 0.81 (95% CI: 0.79 to 0.83) and 0.83 (95% CI: 0.81 to 0.85), respectively.Conclusion:The D:A:D CKD full-risk and short-risk score performed well in predicting CKD events among Asian PLHIV. These risk prediction models may be useful to assist clinicians in identifying individuals at high risk of developing CKD.

Original languageEnglish
Pages (from-to)489-497
Number of pages9
JournalJournal of Acquired Immune Deficiency Syndromes
Issue number4
Publication statusPublished - 2020 Dec 1

Bibliographical note

Funding Information:
Supported by the U.S. National Institutes of Health's National Institute of Allergy and Infectious Diseases; the Eunice Kennedy Shriver National Institute of Child Health and Human Development; the National Cancer Institute; the National Institute of Mental Health; the National Institute on Drug Abuse; the National Heart, Lung, and Blood Institute; the National Institute on Alcohol Abuse and Alcoholism; the National Institute of Diabetes and Digestive and Kidney Diseases; and the Fogarty International Center, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907). The Kirby Institute is funded by the Australian Government Department of Health and Ageing and is affiliated with the Faculty of Medicine, UNSW Sydney. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned above.

Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.

All Science Journal Classification (ASJC) codes

  • Infectious Diseases
  • Pharmacology (medical)


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