51. Glomerular filtration rate and proteinuria associations with coronary artery calcium among HIV-infected and HIV-uninfected men in the Multicenter AIDS Cohort Study
- Author
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Roy, Sion K, Estrella, Michelle M, Darilay, Annie T, Budoff, Matthew J, Jacobson, Lisa P, Witt, Mallory D, Kingsley, Lawrence A, Post, Wendy S, and Palella, Frank J
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Prevention ,Clinical Research ,Heart Disease - Coronary Heart Disease ,Kidney Disease ,Infectious Diseases ,Heart Disease ,HIV/AIDS ,Cardiovascular ,Infection ,Renal and urogenital ,Biomarkers ,Case-Control Studies ,Chi-Square Distribution ,Computed Tomography Angiography ,Coronary Angiography ,Coronary Artery Disease ,Creatinine ,Cross-Sectional Studies ,Glomerular Filtration Rate ,HIV Infections ,HIV Seronegativity ,HIV Seropositivity ,Humans ,Kidney ,Linear Models ,Logistic Models ,Male ,Middle Aged ,Odds Ratio ,Prevalence ,Prospective Studies ,Proteinuria ,Risk Factors ,United States ,Vascular Calcification ,calcium score ,coronary artery disease ,HIV ,kidney disease ,proteinuria ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
BackgroundDecreased kidney function and greater albuminuria are associated with increased incidence and extent of coronary artery calcium (CAC). We investigated whether the associations between kidney function and urine protein-to-creatinine ratio (UPCR) with CAC differ by HIV serostatus.MethodsUsing data from the Multicenter AIDS Cohort Study, a prospective multicenter US study of men who have sex with men, we carried out a cross-sectional study comprised of 592 HIV-infected (HIV+) and 378 uninfected (HIV-) men who underwent noncontrast computed tomography to measure CAC. Logistic and linear regression models were used to determine whether HIV infection modified associations of estimated glomerular filtration rate and UPCR with the presence and extent of CAC, adjusting for age, race, and cardiovascular risk factors.ResultsEvery 10 U decrease in estimated glomerular filtration rate below 90 ml/min/1.73 m was significantly associated with 1.3-fold [95% confidence interval (CI): 1.06-1.51] higher odds of CAC presence and was similar by HIV serostatus (Pinteraction=0.37). Greater UPCR was associated with more extensive CAC, with a change in log CAC score of 0.32 (95% CI: 0.10-0.55) per 1% increase in UPCR. There was a strong trend for effect modification by HIV serostatus for this association [HIV-: 0.75 (95% CI: 0.26-1.25); HIV+: 0.22 (95% CI: -0.03 to 0.47), Pinteraction=0.06].ConclusionGreater CAC burden is apparent among individuals with early kidney disease, irrespective of HIV serostatus. Increased UPCR is associated with a greater extent of CAC with a trend for differences by HIV serostatus; a clearer proteinuria/CAC extent relationship was apparent among HIV- patients.
- Published
- 2017