TY - JOUR
T1 - Association of Kidney Function and Early Kidney Injury with Incident Hypertension in HIV-Infected Women
AU - Ascher, Simon B.
AU - Scherzer, Rebecca
AU - Peralta, Carmen A.
AU - Tien, Phyllis C.
AU - Grunfeld, Carl
AU - Estrella, Michelle M.
AU - Abraham, Alison
AU - Gustafson, Deborah R.
AU - Nowicki, Marek
AU - Sharma, Anjali
AU - Cohen, Mardge H.
AU - Butch, Anthony W.
AU - Young, Mary A.
AU - Bennett, Michael R.
AU - Shlipak, Michael G.
N1 - Publisher Copyright:
© 2017 American Heart Association, Inc.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Subclinical kidney disease is associated with developing hypertension in the general population, but data are lacking among HIV-infected people. We examined associations of kidney function and injury with incident hypertension in 823 HIV-infected and 267 HIV-uninfected women in the Women's Interagency HIV Study, a multicenter, prospective cohort of HIV-infected and uninfected women in the United States. Baseline kidney biomarkers included estimated glomerular filtration rate using cystatin C, urine albumin-To-creatinine ratio, and 7 urine biomarkers of tubular injury: α-1-microglobulin, interleukin-18, kidney injury molecule-1, neutrophil gelatinase-Associated lipocalin, liver fatty acid-binding protein, N-Acetyl-β-d-glucosaminidase, and α1-Acid-glycoprotein. We used multivariable Poisson regression to evaluate associations of kidney biomarkers with incident hypertension, defined as 2 consecutive visits of antihypertensive medication use. During a median follow-up of 9.6 years, 288 HIV-infected women (35%) developed hypertension. Among the HIV-infected women, higher urine albumin-To-creatinine ratio was independently associated with incident hypertension (relative risk =1.13 per urine albumin-To-creatinine ratio doubling, 95% confidence interval, 1.07-1.20), as was lower estimated glomerular filtration rate (relative risk =1.10 per 10 mL/min/1.73 m2 lower estimated glomerular filtration rate; 95% confidence interval, 1.04-1.17). No tubular injury and dysfunction biomarkers were independently associated with incident hypertension in HIV-infected women. In contrast, among the HIV-uninfected women, urine albumin-To-creatinine ratio was not associated with incident hypertension, whereas higher urine interleukin-18, α1-Acid-glycoprotein, and N-Acetyl-β-d-glucosaminidase levels were significantly associated with incident hypertension. These findings suggest that early glomerular injury and kidney dysfunction may be involved in the pathogenesis of hypertension in HIV-infected people. The associations of tubular markers with hypertension in HIV-uninfected women should be validated in other studies.
AB - Subclinical kidney disease is associated with developing hypertension in the general population, but data are lacking among HIV-infected people. We examined associations of kidney function and injury with incident hypertension in 823 HIV-infected and 267 HIV-uninfected women in the Women's Interagency HIV Study, a multicenter, prospective cohort of HIV-infected and uninfected women in the United States. Baseline kidney biomarkers included estimated glomerular filtration rate using cystatin C, urine albumin-To-creatinine ratio, and 7 urine biomarkers of tubular injury: α-1-microglobulin, interleukin-18, kidney injury molecule-1, neutrophil gelatinase-Associated lipocalin, liver fatty acid-binding protein, N-Acetyl-β-d-glucosaminidase, and α1-Acid-glycoprotein. We used multivariable Poisson regression to evaluate associations of kidney biomarkers with incident hypertension, defined as 2 consecutive visits of antihypertensive medication use. During a median follow-up of 9.6 years, 288 HIV-infected women (35%) developed hypertension. Among the HIV-infected women, higher urine albumin-To-creatinine ratio was independently associated with incident hypertension (relative risk =1.13 per urine albumin-To-creatinine ratio doubling, 95% confidence interval, 1.07-1.20), as was lower estimated glomerular filtration rate (relative risk =1.10 per 10 mL/min/1.73 m2 lower estimated glomerular filtration rate; 95% confidence interval, 1.04-1.17). No tubular injury and dysfunction biomarkers were independently associated with incident hypertension in HIV-infected women. In contrast, among the HIV-uninfected women, urine albumin-To-creatinine ratio was not associated with incident hypertension, whereas higher urine interleukin-18, α1-Acid-glycoprotein, and N-Acetyl-β-d-glucosaminidase levels were significantly associated with incident hypertension. These findings suggest that early glomerular injury and kidney dysfunction may be involved in the pathogenesis of hypertension in HIV-infected people. The associations of tubular markers with hypertension in HIV-uninfected women should be validated in other studies.
KW - HIV
KW - albuminuria
KW - glomerular filtration rate
KW - hypertension
KW - kidney disease
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U2 - 10.1161/HYPERTENSIONAHA.116.08258
DO - 10.1161/HYPERTENSIONAHA.116.08258
M3 - Article
C2 - 27993956
AN - SCOPUS:85007273691
SN - 0194-911X
VL - 69
SP - 304
EP - 313
JO - Hypertension
JF - Hypertension
IS - 2
ER -