Association of Kidney Disease With Abnormal Cardiac Structure and Function Among Ugandans With HIV Infection

Area of Science:

• Cardiology
• Nephrology
• Infectious Diseases

Background:

• People with HIV (PWH) have a higher risk of heart and kidney disease.
• The interplay between kidney function and cardiac health in PWH is not well understood.
• It remains unclear if these associations are more pronounced in PWH compared to HIV-uninfected individuals.

Purpose of the Study:

• To investigate the relationship between kidney disease markers and cardiac structure and function in People with HIV (PWH).
• To compare these associations in PWH on antiretroviral therapy versus HIV-uninfected controls in Uganda.

Main Methods:

• A comparative study involving 100 PWH on antiretroviral therapy and 100 HIV-uninfected controls in Uganda.
• Multivariable regression models analyzed associations between estimated glomerular filtration rate (eGFR), albumin-creatinine ratio, and echocardiographic cardiac measures.
• Creatinine-based (eGFRcr) and cystatin C-based eGFR were assessed.

Main Results:

• PWH exhibited lower eGFRcr and a higher prevalence of albumin-creatinine ratio ≥30 compared to controls, even after adjusting for traditional risk factors.
• Lower eGFR was associated with increased left ventricular mass index and diastolic dysfunction, but not systolic function.
• Albuminuria showed a significant association with diastolic dysfunction specifically among PWH (P for interaction = 0.046).

Conclusions:

• In the Ugandan population studied, estimated glomerular filtration rate (eGFR) is linked to elevated left ventricular mass and diastolic dysfunction.
• The association between albuminuria and diastolic dysfunction is notably stronger in People with HIV (PWH).