Markers of renal disease and function are associated with systemic inflammation in HIV infection.

TitleMarkers of renal disease and function are associated with systemic inflammation in HIV infection.
Publication TypeJournal Article
Year of Publication2015
AuthorsGupta SK, Kitch D, Tierney C, Melbourne K, Ha B, McComsey GA
Corporate AuthorsAIDS Clinical Trials Group Study A5224s Team
JournalHIV Med
Volume16
Issue10
Pagination591-8
Date Published2015 Nov
ISSN1468-1293
KeywordsAdult, Biomarkers, Female, Glomerular Filtration Rate, HIV Infections, Humans, Inflammation, Inflammation Mediators, Kidney Diseases, Male, Middle Aged, Molecular Sequence Data, Young Adult
Abstract

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 Clinical Trials Group Study A5224s to determine if markers of renal disease [urine protein:creatinine ratio (uPCR), urine albumin:creatinine ratio (uACR), and estimated glomerular filtration rate (eGFR), 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 (sTNFRI), sTNFRII, 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 eGFR (estimated using CKD-EPI cystatin C-creatinine), uPCR, and uACR were significantly correlated with most assessed markers of systemic inflammation prior to antiretroviral initiation. uPCR and eGFR (using CKD-EPI cystatin C-creatinine), but not uACR, 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. eGFR using CKD-EPI creatinine was much less frequently associated with inflammation markers and only significantly correlated with sTNFR1 at week 0 and with sTNFRI 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.

DOI10.1111/hiv.12268
Alternate JournalHIV Med.
PubMed ID25990642
PubMed Central IDPMC4620540
Grant ListAI0450008 / AI / NIAID NIH HHS / United States
AI065348 / AI / NIAID NIH HHS / United States
AI069424 / AI / NIAID NIH HHS / United States
AI069472 / AI / NIAID NIH HHS / United States
AI38855 / AI / NIAID NIH HHS / United States
AI69501 / AI / NIAID NIH HHS / United States
R01 AI065348 / AI / NIAID NIH HHS / United States
U01 AI038855 / AI / NIAID NIH HHS / United States
U01 AI068634 / AI / NIAID NIH HHS / United States
U01 AI068636 / AI / NIAID NIH HHS / United States
U01 AI069424 / AI / NIAID NIH HHS / United States
U01 AI069472 / AI / NIAID NIH HHS / United States
U01 AI069501 / AI / NIAID NIH HHS / United States
U01 AI68634 / AI / NIAID NIH HHS / United States
UM1 AI068634 / AI / NIAID NIH HHS / United States
UM1 AI068636 / AI / NIAID NIH HHS / United States
UM1 AI106701 / AI / NIAID NIH HHS / United States