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McClean, Mitchell; Buzkova, Petra; Budoff, Matthew; Estrella, Michelle; Freiberg, Matthew; Hodis, Howard N.; Palella, Frank; Shikuma, Cecilia; Post, Wendy S.; Gupta, Samir

Brief Report: Cystatin C-Based Estimation of Glomerular Filtration Rate and Association With Atherosclerosis Imaging Markers in People Living With HIV

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  • Medientyp: E-Artikel
  • Titel: Brief Report: Cystatin C-Based Estimation of Glomerular Filtration Rate and Association With Atherosclerosis Imaging Markers in People Living With HIV
  • Beteiligte: McClean, Mitchell; Buzkova, Petra; Budoff, Matthew; Estrella, Michelle; Freiberg, Matthew; Hodis, Howard N.; Palella, Frank; Shikuma, Cecilia; Post, Wendy S.; Gupta, Samir
  • Erschienen: Ovid Technologies (Wolters Kluwer Health), 2020
  • Erschienen in: JAIDS Journal of Acquired Immune Deficiency Syndromes
  • Sprache: Englisch
  • DOI: 10.1097/qai.0000000000002467
  • ISSN: 1525-4135
  • Schlagwörter: Pharmacology (medical) ; Infectious Diseases
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:sec> <jats:title>Introduction:</jats:title> <jats:p>Reduced estimated glomerular filtration rate (eGFR) is associated with increased risk of cardiovascular disease among people living with HIV (PLWH). It is unclear whether eGFR equations incorporating cystatin C (CysC) measurements are more predictive of preclinical cardiovascular disease than those using only creatinine (Cr).</jats:p> </jats:sec> <jats:sec> <jats:title>Objectives:</jats:title> <jats:p>The study aimed to determine which of the 3 Chronic Kidney Disease Epidemiology (CKD-EPI) eGFR equations is most associated with carotid intima media thickness (CIMT) and coronary artery calcium (CAC) score.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>This cross-sectional analysis of pooled data from 3 large cohorts compared the associations between the 3 CKD-EPI eGFR equations (Cr, CysC, and Cr-CysC) with CIMT and CAC score using multivariable regression analysis. eGFR and CIMT were analyzed as continuous variables. CAC scores were analyzed as a binary variable (detectable calcification versus nondetectable) and as a log10 Agatston score in those with detectable CAC.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>Thousand four hundred eighty-seven participants were included, and of these 910 (562 HIV+ and 348 HIV−) had CIMT measurements and 366 (296 HIV+ and 70 HIV−) had CAC measurements available. In HIV− participants, GFR estimated by any CKD-EPI equation did not significantly correlate with CIMT or CAC scores. When PLWH were analyzed separately including HIV-specific factors, only GFR estimated using Cr-Cys C correlated with CIMT [β= −0.90, 95% CI: (−1.67 to −0.13) μm; <jats:italic toggle="yes">P</jats:italic> = 0.023]. Similarly, eGFR correlated with Agatston scores only when using cystatin C-based eGFR [β= −8.63, 95% CI: (−16.49 to −0.77) HU; <jats:italic toggle="yes">P</jats:italic> = 0.034]. Associations between other eGFR formulas and CAC did not reach statistical significance.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>In PLWH, preclinical atherosclerosis may be more closely correlated with eGFR using formulae that incorporate CysC measurements than Cr alone.</jats:p> </jats:sec>
  • Zugangsstatus: Freier Zugang