Premium
The association of adiposity with kidney function decline among HIV ‐infected adults: findings from the F at R edistribution and M etabolic C hanges in HIV I nfection ( FRAM ) study
Author(s) -
Malkina A,
Scherzer R,
Shlipak MG,
Bacchetti P,
Tien PC,
Grunfeld C,
Kosmiski L,
Peralta CA
Publication year - 2015
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12196
Subject(s) - medicine , renal function , kidney disease , albuminuria , adipose tissue , cohort , endocrinology
Objectives The aim of the study was to investigate the association of adiposity with longitudinal kidney function change in 544 HIV ‐infected persons in the S tudy of F at R edistribution and M etabolic C hange in HIV infection ( FRAM ) cohort over 5 years of follow‐up. Methods The regional distribution of muscle and adipose tissue was quantified by whole‐body magnetic resonance imaging ( MRI ), and total adiponectin and leptin levels were measured in serum. Kidney function was assessed using the estimated glomerular filtration rate from serum cystatin C (e GFRC ys), obtained at baseline and follow‐up. Rapid kidney function decline was defined as annual loss of e GFRC ys ≥ 3 mL/min/1.73 m 2 , and incident chronic kidney disease ( CKD ) was defined as e GFRC ys < 60 mL/min/1.73 m 2 . Multivariate regression analysis was adjusted for age, race, gender, glucose, antihypertensive use, serum albumin, baseline and change in HIV viral load. Results At baseline, mean age was 43 years, mean e GFRC ys was 86 mL/min/1.73 m 2 , and 21% of patients had albuminuria. The mean (± standard deviation) e GFRC ys decline was −0.11 ± 4.87 mL/min/1.73 m 2 per year; 23% of participants had rapid kidney function decline, and 10% developed incident CKD . The lowest tertile of visceral adipose tissue and the highest tertile of adiponectin were both marginally associated with annual kidney function decline of −0.5 mL/min/1.73 m 2 each, but these associations were not statistically significant after adjustment. We found no statistically significant associations of MRI ‐measured regional adiposity or serum adipokines with rapid kidney function decline or incident CKD (all P ‐values > 0.1 in adjusted models). Conclusions Contrary to findings in the general population, adiposity did not have a substantial association with longitudinal change in kidney function among HIV ‐infected persons.