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Increased non-HDL-C level linked with a rapid rate of renal function decline in HIV-infected patients
Masaki Hara1,2, Naoki Yanagisawa3,2, Akihito Ohta1
1Division of Nephrology, Department of Medicine, Tokyo Metropolitan Komagome Hospital, Bunkyo-ku, Tokyo, Japan.
Insights
Elevated non-high-density lipoprotein cholesterol (non-HDL-C) is a significant risk factor for kidney function decline in HIV patients. This finding highlights the importance of managing lipid abnormalities to preserve renal health in this population.
Area of Science:
- Nephrology
- Infectious Diseases
- Cardiovascular Science
Background:
- HIV infection is associated with an increased risk of chronic kidney disease (CKD).
- The specific link between declining renal function and abnormal lipid levels in HIV patients remains under-explored.
Purpose of the Study:
- To investigate the association between dyslipidemia, specifically non-high-density lipoprotein cholesterol (non-HDL-C) levels, and the rate of kidney function decline in HIV-infected individuals.
Main Methods:
- A retrospective cohort study analyzed 661 HIV patients over six years, measuring estimated glomerular filtration rates (eGFRs).
- Linear mixed-effects models assessed annual eGFR decline rates.
- Cochran-Armitage tests and multivariate logistic regression examined the relationship between non-HDL-C levels and eGFR decrease.
Main Results:
- CKD prevalence rose from 8.5% to 21.2% during the study period.
- The average annual eGFR decline rate was 2.01 ml/min/1.73 m²/year, significantly higher than controls.
- Higher non-HDL-C levels correlated with a greater risk of eGFR decline (p=0.0359), with levels above the median being a significant risk factor (OR 1.77).
Conclusions:
- Increased non-HDL-C levels represent a significant risk factor for kidney function deterioration in HIV-infected patients.
- Managing non-HDL-C may be crucial for preventing or slowing CKD progression in this vulnerable population.
Background:
The risk of developing CKD is increased in HIV-infected patients; however, the relationship between renal function decline and lipid abnormalities currently remains unclear in these patients.
Methods:
A retrospective cohort study was conducted on 661 HIV-infected patients, whose estimated glomerular filtration rates (eGFRs) were consecutively measured over 6 years. The rate of declines in eGFR per year was calculated, with decreases being evaluated using a linear mixed effect model. The distribution of decreases in eGFR ≥ 30 % from baseline during the follow-up period was compared across quartiles of non-high-density lipoprotein cholesterol (HDL-C) levels using the Cochran-Armitage test. A multivariate logistic regression model was built to examine the relationship between dyslipidemia and decreases in eGFR.
Results:
The prevalence of CKD increased from 8.5 to 21.2 % during the follow-up. The average of 6 annual eGFR decline rates was 2.01 ± 0.09 ml/min/1.73 m2/year, which was more than 6-fold higher than that of age-matched controls. The distribution of decreases in eGFR significantly increased across the quartiles of non-HDL-C (p value for trend = 0.0359). Non-HDL-C levels greater than the median value of the cohort were identified as a significant risk factor for decreased eGFR [odds ratio (95 % confidence interval), 1.77 (1.07-3.00)].
Conclusion:
Increased non-HDL-C levels are a risk factor for renal function decline in HIV-infected patients.
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