Title | Markers of renal disease and function are associated with systemic inflammation in HIV infection. |
Publication Type | Journal Article |
Year of Publication | 2015 |
Authors | Gupta SK, Kitch D, Tierney C, Melbourne K, Ha B, McComsey GA |
Corporate Authors | AIDS Clinical Trials Group Study A5224s Team |
Journal | HIV Med |
Volume | 16 |
Issue | 10 |
Pagination | 591-8 |
Date Published | 2015 Nov |
ISSN | 1468-1293 |
Keywords | Adult, 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. |
DOI | 10.1111/hiv.12268 |
Alternate Journal | HIV Med. |
PubMed ID | 25990642 |
PubMed Central ID | PMC4620540 |
Grant List | AI0450008 / 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 |