title: Kidney Dysfunction and Markers of Inflammation in the Multicenter AIDS Cohort Study.
abstract: BACKGROUND
  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 m(2)). 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 m(2) (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.
authors.affiliation: Department of Epidemiology.
authors.forename: Alison G
authors.initials: AG
authors.lastname: Abraham
authors.affiliation: Astrazeneca, Gaithersburg, Maryland.
authors.forename: Annie
authors.initials: A
authors.lastname: Darilay
authors.affiliation: Department of Epidemiology.
authors.forename: Heather
authors.initials: H
authors.lastname: McKay
authors.affiliation: Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health.
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Margolick
authors.affiliation: Division of Nephrology, Johns Hopkins School of Medical, Baltimore.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Estrella
authors.affiliation: Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Palella
authors.affiliation: Los Angeles LGBT Center, California.
authors.forename: Robert
authors.initials: R
authors.lastname: Bolan
authors.affiliation: Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pennsylvania.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Rinaldo
authors.affiliation: Department of Epidemiology.
authors.forename: Lisa P
authors.initials: LP
authors.lastname: Jacobson
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D015415:Biomarkers / Q000032:analysis; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005919:Glomerular Filtration Rate; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D018451:Homosexuality, Male; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors
chemical_list: D015415:Biomarkers
keywords: HIV infection; chronic kidney disease; glomerular filtration rate; immune activation; inflammatory markers