Abstract
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.
| Language | English (US) |
|---|---|
| Pages | 304-313 |
| Number of pages | 10 |
| Journal | Hypertension |
| Volume | 69 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 1 2017 |
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Keywords
- albuminuria
- glomerular filtration rate
- HIV
- hypertension
- kidney disease
ASJC Scopus subject areas
- Internal Medicine
Cite this
Association of Kidney Function and Early Kidney Injury with Incident Hypertension in HIV-Infected Women. / Ascher, Simon B.; Scherzer, Rebecca; Peralta, Carmen A.; Tien, Phyllis C.; Grunfeld, Carl; Estrella, Michelle M.; Abraham, Alison; Gustafson, Deborah R.; Nowicki, Marek; Sharma, Anjali; Cohen, Mardge H.; Butch, Anthony W.; Young, Mary A.; Bennett, Michael R.; Shlipak, Michael G.
In: Hypertension, Vol. 69, No. 2, 01.02.2017, p. 304-313.Research output: Contribution to journal › Article
}
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.
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 - albuminuria
KW - glomerular filtration rate
KW - HIV
KW - hypertension
KW - kidney disease
UR - http://www.scopus.com/inward/record.url?scp=85007273691&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85007273691&partnerID=8YFLogxK
U2 - 10.1161/HYPERTENSIONAHA.116.08258
DO - 10.1161/HYPERTENSIONAHA.116.08258
M3 - Article
VL - 69
SP - 304
EP - 313
JO - Hypertension
T2 - Hypertension
JF - Hypertension
SN - 0194-911X
IS - 2
ER -