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Kidney function and the risk of cardiovascular events in HIV-1-infected patients

Elizabeth George1, Gregory M Lucas, Girish N Nadkarni

  • 1All India Institute of Medical Sciences, New Delhi, India.

AIDS (London, England)
|December 19, 2009
PubMed

Insights

Reduced kidney function and proteinuria significantly increase cardiovascular event risk in HIV patients. This highlights the importance of monitoring kidney health to prevent cardiovascular complications in this population.

Area of Science:

  • Nephrology
  • Cardiology
  • Infectious Diseases

Background:

  • Cardiovascular events (CVEs) are a major cause of mortality in individuals with HIV/AIDS.
  • Kidney function impairment is increasingly recognized as a risk factor for CVEs.

Purpose of the Study:

  • To investigate the association between kidney function and the risk of CVEs in HIV-infected patients.
  • To determine if proteinuria is an independent predictor of CVEs in this cohort.

Main Methods:

  • A nested, matched, case-control study was conducted with 315 HIV-infected patients (63 cases with CVEs, 252 controls).
  • Estimated glomerular filtration rate (eGFR) and proteinuria were assessed as primary exposures.
  • eGFR was calculated using the CKD-EPI and MDRD equations.

Main Results:

  • Patients with CVEs had significantly lower mean eGFR compared to controls (P < 0.001).
  • An eGFR < 60 ml/min/1.73 m² was associated with a 15.9-fold increased odds of CVEs (P < 0.001).
  • Proteinuria was present in approximately double the proportion of cases vs. controls (51% vs. 25%, P < 0.001) and was independently associated with CVEs.

Conclusions:

  • Decreased kidney function, indicated by lower eGFR and proteinuria, is significantly and independently associated with an increased risk of CVEs in HIV-1-infected patients.
  • These findings underscore the critical role of renal health in cardiovascular risk stratification for HIV-infected individuals.
Abstract

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