Cystatin C based estimation of glomerular filtration rate and association with atherosclerosis imaging markers in people living with HIV

dc.contributor.authorMcclean, Mitchell
dc.contributor.authorBuzkova, Petra
dc.contributor.authorBudoff, Matthew
dc.contributor.authorEstrella, Michelle
dc.contributor.authorFreiberg, Matthew
dc.contributor.authorHodis, Howard N.
dc.contributor.authorPalella, Frank
dc.contributor.authorShikuma, Cecilia
dc.contributor.authorPost, Wendy S.
dc.contributor.authorGupta, Samir
dc.contributor.departmentMedicine, School of Medicineen_US
dc.date.accessioned2020-10-02T20:15:50Z
dc.date.available2020-10-02T20:15:50Z
dc.date.issued2020-07
dc.description.abstractIntroduction: 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 CVD than those using only creatinine (Cr). Objectives: The study aimed to determine which of the three Chronic Kidney Disease Epidemiology (CKD-EPI) eGFR equations is most associated with carotid intima media thickness (CIMT) and coronary artery calcium (CAC) score. Methods: This cross-sectional analysis of pooled data from three large cohorts compared the associations between the three 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. Results: 1487 participants were included, and of these 910 (562 HIV+, 348 HIV-) had CIMT measurements and 366 (296 HIV+, 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,-0.13) μm; p=0.023]. Similarly, eGFR correlated with Agatston scores only when using cystatin C-based eGFR [β= -8.63, 95% CI (-16.49,-0.77) HU; p=0.034]. Associations between other eGFR formulas and CAC did not reach statistical significance. Conclusion: In PLWH, preclinical atherosclerosis may be more closely correlated with eGFR using formulae that incorporate CysC measurements than Cr alone.en_US
dc.eprint.versionAuthor's manuscripten_US
dc.identifier.citationMcclean, M., Buzkova, P., Budoff, M., Estrella, M., Freiberg, M., Hodis, H. N., Palella, F., Shikuma, C., Post, W. S., & Gupta, S. (2020). Cystatin C based estimation of glomerular filtration rate and association with atherosclerosis imaging markers in people living with HIV. JAIDS Journal of Acquired Immune Deficiency Syndromes, Publish Ahead of Print. https://doi.org/10.1097/QAI.0000000000002467en_US
dc.identifier.urihttps://hdl.handle.net/1805/23973
dc.language.isoenen_US
dc.publisherWolters Kluweren_US
dc.relation.isversionof10.1097/QAI.0000000000002467en_US
dc.relation.journalJournal of Acquired Immune Deficiency Syndromesen_US
dc.rightsPublisher Policyen_US
dc.sourceAuthoren_US
dc.subjectHIV-1en_US
dc.subjectCystatin Cen_US
dc.subjectcarotid intima media thicknessen_US
dc.titleCystatin C based estimation of glomerular filtration rate and association with atherosclerosis imaging markers in people living with HIVen_US
dc.typeArticleen_US
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