Factors affecting glomerular filtration rate, as measured by iohexol disappearance, in men with or at risk for HIV infection.

Abstract

OBJECTIVE:

Formulae used to estimate glomerular filtration rate (GFR) underestimate higher GFRs and have not been well-studied in HIV-infected (HIV(+)) people; we evaluated the relationships of HIV infection and known or potential risk factors for kidney disease with directly measured GFR and the presence of chronic kidney disease (CKD).

DESIGN:

Cross-sectional measurement of iohexol-based GFR (iGFR) in HIV(+) men (n = 455) receiving antiretroviral therapy, and HIV-uninfected (HIV(-)) men (n = 258) in the Multicenter AIDS Cohort Study.

METHODS:

iGFR was calculated from disappearance of infused iohexol from plasma. Determinants of GFR and the presence of CKD were compared using iGFR and GFR estimated by the CKD-Epi equation (eGFR).

RESULTS:

Median iGFR was higher among HIV(+) than HIV(-) men (109 vs. 106 ml/min/1.73 m(2), respectively, p = .046), and was 7 ml/min higher than median eGFR. Mean iGFR was lower in men who were older, had chronic hepatitis C virus (HCV) infection, or had a history of AIDS. Low iGFR (≤90 ml/min/1.73 m(2)) was associated with these factors and with black race. Other than age, factors associated with low iGFR were not observed with low eGFR. CKD was more common in HIV(+) than HIV(-) men; predictors of CKD were similar using iGFR and eGFR.

CONCLUSIONS:

iGFR was higher than eGFR in this population of HIV-infected and -uninfected men who have sex with men. Presence of CKD was predicted equally well by iGFR and eGFR, but associations of chronic HCV infection and history of clinically-defined AIDS with mildly decreased GFR were seen only with iGFR.

• Authors: Joseph B Margolick, Lisa P Jacobson, George J Schwartz, Alison G Abraham, Annie T Darilay, Lawrence A Kingsley, Mallory D Witt, Frank J Palella Jr
• Journal: PloS one (PLoS One) Vol. 9 Issue 2 Pg. e86311 ( 2014) ISSN: 1932-6203 [Electronic] United States
• PMID: 24516530 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Retroviral Agents
• Iohexol

Topics

• Adult
• Anti-Retroviral Agents (therapeutic use)
• Cross-Sectional Studies
• Glomerular Filtration Rate (physiology)
• HIV Infections (complications, drug therapy, physiopathology)
• Humans
• Iohexol
• Male
• Middle Aged
• Renal Insufficiency, Chronic (complications, diagnosis, physiopathology)