Kidney Dysfunction and Markers of Inflammation in the Multicenter AIDS Cohort Study

Alison G. Abraham*, Annie Darilay, Heather McKay, Joseph B. Margolick, Michelle M. Estrella, Frank J. Palella, Robert Bolan, Charles R. Rinaldo, Lisa P. Jacobson

*Corresponding author for this work

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Human immunodeficiency virus (HIV)-infected individuals are at higher risk for chronic kidney disease than HIV-uninfected individuals. We investigated whether the inflammation present in treated HIV infection contributes to kidney dysfunction among HIV-infected men receiving highly active antiretroviral therapy. Methods. The glomerular filtration rate (GFR) was directly measured (using iohexol) along with 12 markers of inflammation in Multicenter AIDS Cohort Study participants. Exploratory factor analysis was used to identify inflammatory processes related to kidney dysfunction. The estimated levels of these inflammatory processes were used in adjusted logistic regression analyses evaluating cross-sectional associations with kidney function outcomes. Results. There were 434 HIV-infected men receiving highly active antiretroviral therapy and 200 HIV-uninfected men. HIV-infected men were younger (median age, 51 vs 53 years) and had higher urine protein-creatinine ratios (median, 98 vs 66 mg/g) but comparable GFRs (median, 109 vs 106 mL/min|1.73 m2). We found an inflammatory process dominated by markers: soluble tumor necrosis factor receptor 2, soluble interleukin 2 receptor α, soluble gp130, soluble CD27, and soluble CD14. An increase of 1 standard deviation in that inflammatory process was associated with significantly greater odds of GFR ≤ 90 mL/min/1.73 m2 (odds ratio, 2.0) and urine protein >200 mg/g (odds ratio, 2.3). Conclusions. Higher circulating levels of immune activation markers among treated HIV-infected men may partially explain their higher burden of kidney dysfunction compared with uninfected men.

Original languageEnglish (US)
Pages (from-to)1100-1110
Number of pages11
JournalJournal of Infectious Diseases
Volume212
Issue number7
DOIs
StatePublished - Oct 1 2015

Keywords

  • HIV infection
  • chronic kidney disease
  • glomerular filtration rate
  • immune activation
  • inflammatory markers

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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    Abraham, A. G., Darilay, A., McKay, H., Margolick, J. B., Estrella, M. M., Palella, F. J., Bolan, R., Rinaldo, C. R., & Jacobson, L. P. (2015). Kidney Dysfunction and Markers of Inflammation in the Multicenter AIDS Cohort Study. Journal of Infectious Diseases, 212(7), 1100-1110. https://doi.org/10.1093/infdis/jiv159