Reduced Kidney Function and Preclinical Atherosclerosis in HIV-Infected Individuals: The Study of Fat Redistribution and Metabolic Change in HIV Infection (FRAM)

Year: 2011

Type: article

Abstract: BACKGROUND/AIMS: Reduced kidney function and albuminuria are associated with higher risk for cardiovascular disease (CVD) and mortality in HIV-infected individuals. We investigated whether reduced estimated glomerular filtration rate (eGFR) and albuminuria are associated with subclinical vascular disease, as assessed by carotid intima-medial thickness (cIMT). METHODS: Cross-sectional analysis of 476 HIV-infected individuals without clinical evidence of CVD enrolled in the Fat Redistribution and Metabolic Change in HIV infection (FRAM) study, using multivariable linear regression. eGFR(Cys) and eGFR(Cr) were calculated from cystatin C and creatinine levels. Albuminuria was defined as a positive urine dipstick (≥ 1+) or urine albumin-to-creatinine ratio ≥ 30 mg/g. Common and internal cIMT were measured by high-resolution B-mode ultrasound. RESULTS: In unadjusted analyses, eGFR(Cys) and eGFR(Cr) were strongly associated with com- mon and internal cIMT. Each 10 ml/min/1.73 m2 decrease in eGFR(Cys) and eGFR(cr) was associated with a 0.008 mm higher common cIMT (p = 0.003, p = 0.01) and a 0.024 and 0.029 mm higher internal cIMT (p = 0.003), respectively. These associations were eliminated after adjustment for age, gender, and race. Albuminuria showed little association with common or internal cIMT in all models. CONCLUSIONS: In HIV-infected individuals without prior CVD, reduced kidney function and albuminuria were not independently associated with subclinical vascular disease, as assessed by cIMT. These results suggest that research should focus on searching for novel mechanisms by which kidney disease confers cardiovascular risk in HIV-infected individuals.

Source: American Journal of Nephrology

DOI: 10.1159/000327606

Authors: Vasantha Jotwani, Rebecca Scherzer, Andy Choi, Lynda Szczech, Joseph F. Polak, Richard A. Kronmal, Carl Grunfeld, Michael Shlipak

Institutions: San Francisco VA Medical Center, University of California, San Francisco, University of California System, Duke Medical Center, Tufts Medical Center, University of Washington

Language: English

Subfield: Emergency Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: bronze

Funders: U.S. Department of Veterans Affairs, Deutsches Krebsforschungszentrum, National Institutes of Health, National Heart, Lung, and Blood Institute, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Research Resources

OpenAlex ID: W1982829534