{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T11:18:00Z","timestamp":1782386280835,"version":"3.54.5"},"reference-count":31,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"crossref","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,11,10]]},"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to assess whether an excess mortality related to kidney and other urinary tract diseases exists among Italian people with AIDS (PWA), as compared with the general population without AIDS (non-PWA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Population-based, retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and participants<\/jats:title>\n                    <jats:p>We conducted a nationwide study including 9481 Italian PWA, aged 15\u201374 years, reported to the National AIDS Registry between 2006 and 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Vital status and causes of death were retrieved by record linkage with the National Register of Causes of Death up to 2018. Excess mortality for PWA versus non-PWA was estimated through sex-standardised and age-standardised mortality ratios (SMRs) with corresponding 95% CIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 2613 deceased PWA, 262 (10.0%) reported at least one urinary tract disease at death, including 254 (9.7%) non-cancer diseases\u2014mostly renal failures (225 cases, 8.6%)\u2014and 9 cancers (0.3%). The overall SMR for non-cancer urinary tract diseases was 15.3 (95% CI 13.4 to 17.3) with statistically significant SMRs for acute (SMR=22.3, 95% CI 18.0 to 27.4), chronic (SMR=8.4, 95% CI 6.0 to 11.3), and unspecified renal failure (SMR=13.8, 95% CI 11.2 to 16.8). No statistically significant excess mortality was detected for urinary tract cancers (SMR=1.7, 95% CI 0.8 to 3.3). The SMRs were particularly elevated among PWA aged &lt;50 years, injecting drug users, or those with the first HIV-positive test &gt;6 months before AIDS diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The excess mortality related to non-cancer kidney and other urinary tract diseases reported among PWA highlights the importance of implementing the recommendation for screening, diagnosis and management of such conditions among this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-064970","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T13:53:44Z","timestamp":1669902824000},"page":"e064970","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Increased kidney disease mortality among people with AIDS versus the general population: a population-based cohort study in Italy, 2006\u20132018"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6731-7569","authenticated-orcid":false,"given":"Martina","family":"Taborelli","sequence":"first","affiliation":[{"name":"Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Suligoi","sequence":"additional","affiliation":[{"name":"Centro Operativo AIDS, Istituto Superiore di Sanit\u00e0, Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Serraino","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Frova","sequence":"additional","affiliation":[{"name":"Integrated system for health, social assistance and welfare, Istituto Nazionale di Statistica, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Grande","sequence":"additional","affiliation":[{"name":"Integrated system for health, social assistance and welfare, Istituto Nazionale di Statistica, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Toffolutti","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenza","family":"Regine","sequence":"additional","affiliation":[{"name":"Centro Operativo AIDS, Istituto Superiore di Sanit\u00e0, Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilena","family":"Pappagallo","sequence":"additional","affiliation":[{"name":"Integrated system for health, social assistance and welfare, Istituto Nazionale di Statistica, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Centro Operativo AIDS, Istituto Superiore di Sanit\u00e0, Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Grippo","sequence":"additional","affiliation":[{"name":"Integrated system for health, social assistance and welfare, Istituto Nazionale di Statistica, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Zucchetto","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,12,1]]},"reference":[{"key":"2025121605034098000_12.12.e064970.1","doi-asserted-by":"publisher","DOI":"10.1086\/652283"},{"key":"2025121605034098000_12.12.e064970.2","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-012-0293-y"},{"key":"2025121605034098000_12.12.e064970.3","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2014.0079"},{"key":"2025121605034098000_12.12.e064970.4","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000078"},{"key":"2025121605034098000_12.12.e064970.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60604-8"},{"key":"2025121605034098000_12.12.e064970.6","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0129550"},{"key":"2025121605034098000_12.12.e064970.7","doi-asserted-by":"crossref","DOI":"10.1002\/jia2.25031","article-title":"Increased non-AIDS mortality among persons with AIDS-defining events after antiretroviral therapy initiation","volume":"21","author":"Pettit","year":"2018","journal-title":"J Int AIDS Soc"},{"key":"2025121605034098000_12.12.e064970.8","doi-asserted-by":"crossref","first-page":"14","DOI":"10.2174\/1874613601509010014","article-title":"Comparison of rates of death having any death-certificate mention of heart, kidney, or liver disease among persons diagnosed with HIV infection with those in the general US population, 2009-2011","volume":"9","author":"Whiteside","year":"2015","journal-title":"Open AIDS J"},{"key":"2025121605034098000_12.12.e064970.9","doi-asserted-by":"crossref","first-page":"e35","DOI":"10.1016\/S2468-2667(16)30020-2","article-title":"Mortality and causes of death in people diagnosed with HIV in the era of highly active antiretroviral therapy compared with the general population: an analysis of a national observational cohort","volume":"2","author":"Croxford","year":"2017","journal-title":"Lancet Public Health"},{"key":"2025121605034098000_12.12.e064970.10","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1097\/QAI.0000000000001033","article-title":"Non-AIDS-defining cancer mortality: emerging patterns in the late HAART era","volume":"73","author":"Zucchetto","year":"2016","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2025121605034098000_12.12.e064970.11","doi-asserted-by":"crossref","DOI":"10.1186\/s12963-017-0135-3","article-title":"Multiple cause-of-death data among people with AIDS in Italy: a nationwide cross-sectional study","volume":"15","author":"Grande","year":"2017","journal-title":"Popul Health Metr"},{"key":"2025121605034098000_12.12.e064970.12","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-018-3336-x","article-title":"Excess mortality related to circulatory system diseases and diabetes mellitus among Italian AIDS patients vs. non-AIDS population: a population-based cohort study using the multiple causes-of-death approach","volume":"18","author":"Suligoi","year":"2018","journal-title":"BMC Infect Dis"},{"key":"2025121605034098000_12.12.e064970.13","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1111\/hiv.12937","article-title":"Excess liver-related mortality among people with AIDS compared to the general population: an Italian nationwide cohort study using multiple causes of death","volume":"21","author":"Taborelli","year":"2020","journal-title":"HIV Med"},{"key":"2025121605034098000_12.12.e064970.14","doi-asserted-by":"crossref","DOI":"10.1186\/s12981-020-00266-3","article-title":"Contemporary issues and new challenges in chronic kidney disease amongst people living with HIV","volume":"17","author":"Heron","year":"2020","journal-title":"AIDS Res Ther"},{"key":"2025121605034098000_12.12.e064970.15","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000653"},{"key":"2025121605034098000_12.12.e064970.16","doi-asserted-by":"crossref","first-page":"2363","DOI":"10.1056\/NEJMra1508467","article-title":"Kidney diseases associated with human immunodeficiency virus infection","volume":"377","author":"Cohen","year":"2017","journal-title":"N Engl J Med"},{"key":"2025121605034098000_12.12.e064970.17","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-029211"},{"key":"2025121605034098000_12.12.e064970.18","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-015-0960-6","article-title":"Risk factors for early mortality after AIDS in the cART era: a population-based cohort study in Italy","volume":"15","author":"Suligoi","year":"2015","journal-title":"BMC Infect Dis"},{"key":"2025121605034098000_12.12.e064970.19","unstructured":"ISTAT INdS . ISTAT. multiple causes of death Rome, Italy: Istituto Nazionale di Statistica; 2018, 2022. Available: http:\/\/siqual.istat.it\/SIQual\/visualizza.do?id=5000131 [Accessed 04 Feb 2022]."},{"key":"2025121605034098000_12.12.e064970.20","doi-asserted-by":"crossref","DOI":"10.1016\/0140-6736(93)93040-8","article-title":"Expanded European AIDS case definition","volume":"341","author":"Ancelle-Park","year":"1993","journal-title":"Lancet"},{"key":"2025121605034098000_12.12.e064970.21","doi-asserted-by":"publisher","DOI":"10.1006\/jbin.2002.1036"},{"key":"2025121605034098000_12.12.e064970.22","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dji072"},{"key":"2025121605034098000_12.12.e064970.23","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2014.44"},{"key":"2025121605034098000_12.12.e064970.24","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfw104"},{"key":"2025121605034098000_12.12.e064970.25","first-page":"2660","article-title":"Kidney disease in HIV-infected patients","volume":"17","author":"Scarpino","year":"2013","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"2025121605034098000_12.12.e064970.26","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1097\/COH.0000000000000703","article-title":"Renal adverse drug reactions","volume":"16","author":"Hughes","year":"2021","journal-title":"Curr Opin HIV AIDS"},{"key":"2025121605034098000_12.12.e064970.27","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1159\/000457130","article-title":"HIV-associated urogenital malignancies","volume":"40","author":"Hentrich","year":"2017","journal-title":"Oncol Res Treat"},{"key":"2025121605034098000_12.12.e064970.28","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-20-1045"},{"key":"2025121605034098000_12.12.e064970.29","doi-asserted-by":"crossref","first-page":"e240","DOI":"10.1016\/S1470-2045(21)00137-6","article-title":"The effect of non-AIDS-defining cancers on people living with HIV","volume":"22","author":"Chiao","year":"2021","journal-title":"Lancet Oncol"},{"key":"2025121605034098000_12.12.e064970.30","doi-asserted-by":"crossref","first-page":"e224","DOI":"10.1093\/cid\/ciaa1016","article-title":"Deaths attributable to cancer in the US human immunodeficiency virus population during 2001-2015","volume":"72","author":"Horner","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2025121605034098000_12.12.e064970.31","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2017.11.007"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2022-064970","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T13:03:50Z","timestamp":1765890230000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2022-064970"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12]]},"references-count":31,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12,1]]},"published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1136\/bmjopen-2022-064970"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2022-064970","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12]]}}}