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Markers of renal disease and function are associated with systemic inflammation in HIV infection
Author(s) -
Gupta SK,
Kitch D,
Tierney C,
Melbourne K,
Ha B,
McComsey GA
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.12268
Subject(s) - renal function , medicine , creatinine , cystatin c , kidney disease , albuminuria , systemic inflammation , proteinuria , inflammation , gastroenterology , urology , immunology , kidney
Objectives Both renal disease and systemic inflammation predict non‐ AIDS ‐defining events and overall mortality in HIV ‐infected patients. Here, we sought to determine the relationships between renal disease and circulating inflammation markers. Methods We performed a secondary analysis of AIDS C linical T rials G roup S tudy A 5224s to determine if markers of renal disease [urine protein:creatinine ratio (u PCR ), urine albumin:creatinine ratio (u ACR ), and estimated glomerular filtration rate (e GFR ), using Chronic Kidney Disease Epidemiology Collaboration ( CKD ‐ EPI ) creatinine and cystatin C ‐creatinine] were associated with markers of systemic inflammation [high‐sensitivity C ‐reactive protein, interleukin‐6, tumour necrosis factor ( TNF )‐α, soluble TNF ‐α receptor I (s TNFRI ), s TNFRII , and soluble vascular cellular and intercellular adhesion molecules]. We correlated these renal and inflammatory markers prior to antiretroviral initiation and after 96 weeks of therapy. Results We found that e GFR (estimated using CKD ‐ EPI cystatin C ‐creatinine), u PCR , and u ACR were significantly correlated with most assessed markers of systemic inflammation prior to antiretroviral initiation. u PCR and e GFR (using CKD‐EPI cystatin C ‐creatinine), but not u ACR , remained significantly correlated with most of the assessed inflammatory markers after 96 weeks of antiretroviral therapy ( ART ). Most of these correlations, although statistically significant, were < 0.50. e GFR using CKD‐EPI creatinine was much less frequently associated with inflammation markers and only significantly correlated with s TNFR 1 at week 0 and with s TNFRI and II at week 96. Conclusions Renal disease and function were associated with systemic inflammation in HIV infection, both before and after ART . Systemic inflammation may partially explain the relationships between proteinuria, albuminuria, and reduced renal function and future adverse outcomes.