Serum albumin and kidney function decline in HIV-infected women

Joshua Lang, Rebecca Scherzer, Phyllis C. Tien, Chirag Parikh, Kathryn Anastos, Michelle M. Estrella, Alison Gump Abraham, Anjali Sharma, Mardge H. Cohen, Anthony W. Butch, Marek Nowicki, Carl Grunfeld, Michael G. Shlipak

Research output: Contribution to journalArticle

Abstract

Background Serum albumin concentrations are a strong predictor of mortality and cardiovascular disease in human immunodeficiency virus (HIV)-infected individuals. We studied the longitudinal associations between serum albumin levels and kidney function decline in a population of HIV-infected women.

Study Design Retrospective cohort analysis.

Setting & Participants Study participants were recruited from the Women's Interagency HIV Study (WIHS), a large observational study designed to understand risk factors for the progression of HIV infection in women living in urban communities. 908 participants had baseline assessment of kidney function and 2 follow-up measurements over an average of 8 years.

Predictor The primary predictor was serum albumin concentration.

Outcomes We examined annual change in kidney function. Secondary outcomes included rapid kidney function decline and incident reduced estimated glomerular filtration rate (eGFR).

Measurements Kidney function decline was determined by cystatin C-based (eGFRcys) and creatinine-based eGFR (eGFRcr) at baseline and follow-up. Each model was adjusted for kidney disease and HIV-related risk factors using linear and relative risk regression.

Results After multivariate adjustment, each 0.5-g/dL decrement in baseline serum albumin concentration was associated with a 0.56-mL/min faster annual decline in eGFRcys (P <0.001), which was attenuated only slightly to 0.55 mL/min/1.73 m2 after adjustment for albuminuria. Results were similar whether using eGFRcys or eGFRcr. In adjusted analyses, each 0.5-g/dL lower baseline serum albumin level was associated with a 1.71-fold greater risk of rapid kidney function decline (P <0.001) and a 1.72-fold greater risk of incident reduced eGFR (P <0.001).

Limitations The cohort is composed of only female participants from urban communities within the United States.

Conclusions Lower serum albumin levels were associated strongly with kidney function decline and incident reduced eGFRs in HIV-infected women independent of HIV disease status, body mass index, and albuminuria.

Original languageEnglish (US)
Pages (from-to)584-591
Number of pages8
JournalAmerican Journal of Kidney Diseases
Volume64
Issue number4
DOIs
StatePublished - Oct 1 2014

Fingerprint

Serum Albumin
HIV
Kidney
Glomerular Filtration Rate
Albuminuria
Virus Diseases
Creatinine
Cystatin C
Kidney Diseases
Observational Studies
Body Mass Index
Cohort Studies
Cardiovascular Diseases
Retrospective Studies
Mortality
Population

Keywords

  • Albumin
  • albuminuria
  • chronic kidney disease (CKD) progression
  • disease trajectory
  • HIV (human immunodeficiency virus)
  • incident reduced estimated glomerular filtration rate (eGFR)
  • kidney function

ASJC Scopus subject areas

  • Nephrology
  • Medicine(all)

Cite this

Lang, J., Scherzer, R., Tien, P. C., Parikh, C., Anastos, K., Estrella, M. M., ... Shlipak, M. G. (2014). Serum albumin and kidney function decline in HIV-infected women. American Journal of Kidney Diseases, 64(4), 584-591. https://doi.org/10.1053/j.ajkd.2014.05.015

Serum albumin and kidney function decline in HIV-infected women. / Lang, Joshua; Scherzer, Rebecca; Tien, Phyllis C.; Parikh, Chirag; Anastos, Kathryn; Estrella, Michelle M.; Abraham, Alison Gump; Sharma, Anjali; Cohen, Mardge H.; Butch, Anthony W.; Nowicki, Marek; Grunfeld, Carl; Shlipak, Michael G.

In: American Journal of Kidney Diseases, Vol. 64, No. 4, 01.10.2014, p. 584-591.

Research output: Contribution to journalArticle

Lang, J, Scherzer, R, Tien, PC, Parikh, C, Anastos, K, Estrella, MM, Abraham, AG, Sharma, A, Cohen, MH, Butch, AW, Nowicki, M, Grunfeld, C & Shlipak, MG 2014, 'Serum albumin and kidney function decline in HIV-infected women', American Journal of Kidney Diseases, vol. 64, no. 4, pp. 584-591. https://doi.org/10.1053/j.ajkd.2014.05.015
Lang, Joshua ; Scherzer, Rebecca ; Tien, Phyllis C. ; Parikh, Chirag ; Anastos, Kathryn ; Estrella, Michelle M. ; Abraham, Alison Gump ; Sharma, Anjali ; Cohen, Mardge H. ; Butch, Anthony W. ; Nowicki, Marek ; Grunfeld, Carl ; Shlipak, Michael G. / Serum albumin and kidney function decline in HIV-infected women. In: American Journal of Kidney Diseases. 2014 ; Vol. 64, No. 4. pp. 584-591.
@article{7c806401783d41eeaa94aa265c60c409,
title = "Serum albumin and kidney function decline in HIV-infected women",
abstract = "Background Serum albumin concentrations are a strong predictor of mortality and cardiovascular disease in human immunodeficiency virus (HIV)-infected individuals. We studied the longitudinal associations between serum albumin levels and kidney function decline in a population of HIV-infected women.Study Design Retrospective cohort analysis.Setting & Participants Study participants were recruited from the Women's Interagency HIV Study (WIHS), a large observational study designed to understand risk factors for the progression of HIV infection in women living in urban communities. 908 participants had baseline assessment of kidney function and 2 follow-up measurements over an average of 8 years.Predictor The primary predictor was serum albumin concentration.Outcomes We examined annual change in kidney function. Secondary outcomes included rapid kidney function decline and incident reduced estimated glomerular filtration rate (eGFR).Measurements Kidney function decline was determined by cystatin C-based (eGFRcys) and creatinine-based eGFR (eGFRcr) at baseline and follow-up. Each model was adjusted for kidney disease and HIV-related risk factors using linear and relative risk regression.Results After multivariate adjustment, each 0.5-g/dL decrement in baseline serum albumin concentration was associated with a 0.56-mL/min faster annual decline in eGFRcys (P <0.001), which was attenuated only slightly to 0.55 mL/min/1.73 m2 after adjustment for albuminuria. Results were similar whether using eGFRcys or eGFRcr. In adjusted analyses, each 0.5-g/dL lower baseline serum albumin level was associated with a 1.71-fold greater risk of rapid kidney function decline (P <0.001) and a 1.72-fold greater risk of incident reduced eGFR (P <0.001).Limitations The cohort is composed of only female participants from urban communities within the United States.Conclusions Lower serum albumin levels were associated strongly with kidney function decline and incident reduced eGFRs in HIV-infected women independent of HIV disease status, body mass index, and albuminuria.",
keywords = "Albumin, albuminuria, chronic kidney disease (CKD) progression, disease trajectory, HIV (human immunodeficiency virus), incident reduced estimated glomerular filtration rate (eGFR), kidney function",
author = "Joshua Lang and Rebecca Scherzer and Tien, {Phyllis C.} and Chirag Parikh and Kathryn Anastos and Estrella, {Michelle M.} and Abraham, {Alison Gump} and Anjali Sharma and Cohen, {Mardge H.} and Butch, {Anthony W.} and Marek Nowicki and Carl Grunfeld and Shlipak, {Michael G.}",
year = "2014",
month = "10",
day = "1",
doi = "10.1053/j.ajkd.2014.05.015",
language = "English (US)",
volume = "64",
pages = "584--591",
journal = "American Journal of Kidney Diseases",
issn = "0272-6386",
publisher = "W.B. Saunders Ltd",
number = "4",

}

TY - JOUR

T1 - Serum albumin and kidney function decline in HIV-infected women

AU - Lang, Joshua

AU - Scherzer, Rebecca

AU - Tien, Phyllis C.

AU - Parikh, Chirag

AU - Anastos, Kathryn

AU - Estrella, Michelle M.

AU - Abraham, Alison Gump

AU - Sharma, Anjali

AU - Cohen, Mardge H.

AU - Butch, Anthony W.

AU - Nowicki, Marek

AU - Grunfeld, Carl

AU - Shlipak, Michael G.

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Background Serum albumin concentrations are a strong predictor of mortality and cardiovascular disease in human immunodeficiency virus (HIV)-infected individuals. We studied the longitudinal associations between serum albumin levels and kidney function decline in a population of HIV-infected women.Study Design Retrospective cohort analysis.Setting & Participants Study participants were recruited from the Women's Interagency HIV Study (WIHS), a large observational study designed to understand risk factors for the progression of HIV infection in women living in urban communities. 908 participants had baseline assessment of kidney function and 2 follow-up measurements over an average of 8 years.Predictor The primary predictor was serum albumin concentration.Outcomes We examined annual change in kidney function. Secondary outcomes included rapid kidney function decline and incident reduced estimated glomerular filtration rate (eGFR).Measurements Kidney function decline was determined by cystatin C-based (eGFRcys) and creatinine-based eGFR (eGFRcr) at baseline and follow-up. Each model was adjusted for kidney disease and HIV-related risk factors using linear and relative risk regression.Results After multivariate adjustment, each 0.5-g/dL decrement in baseline serum albumin concentration was associated with a 0.56-mL/min faster annual decline in eGFRcys (P <0.001), which was attenuated only slightly to 0.55 mL/min/1.73 m2 after adjustment for albuminuria. Results were similar whether using eGFRcys or eGFRcr. In adjusted analyses, each 0.5-g/dL lower baseline serum albumin level was associated with a 1.71-fold greater risk of rapid kidney function decline (P <0.001) and a 1.72-fold greater risk of incident reduced eGFR (P <0.001).Limitations The cohort is composed of only female participants from urban communities within the United States.Conclusions Lower serum albumin levels were associated strongly with kidney function decline and incident reduced eGFRs in HIV-infected women independent of HIV disease status, body mass index, and albuminuria.

AB - Background Serum albumin concentrations are a strong predictor of mortality and cardiovascular disease in human immunodeficiency virus (HIV)-infected individuals. We studied the longitudinal associations between serum albumin levels and kidney function decline in a population of HIV-infected women.Study Design Retrospective cohort analysis.Setting & Participants Study participants were recruited from the Women's Interagency HIV Study (WIHS), a large observational study designed to understand risk factors for the progression of HIV infection in women living in urban communities. 908 participants had baseline assessment of kidney function and 2 follow-up measurements over an average of 8 years.Predictor The primary predictor was serum albumin concentration.Outcomes We examined annual change in kidney function. Secondary outcomes included rapid kidney function decline and incident reduced estimated glomerular filtration rate (eGFR).Measurements Kidney function decline was determined by cystatin C-based (eGFRcys) and creatinine-based eGFR (eGFRcr) at baseline and follow-up. Each model was adjusted for kidney disease and HIV-related risk factors using linear and relative risk regression.Results After multivariate adjustment, each 0.5-g/dL decrement in baseline serum albumin concentration was associated with a 0.56-mL/min faster annual decline in eGFRcys (P <0.001), which was attenuated only slightly to 0.55 mL/min/1.73 m2 after adjustment for albuminuria. Results were similar whether using eGFRcys or eGFRcr. In adjusted analyses, each 0.5-g/dL lower baseline serum albumin level was associated with a 1.71-fold greater risk of rapid kidney function decline (P <0.001) and a 1.72-fold greater risk of incident reduced eGFR (P <0.001).Limitations The cohort is composed of only female participants from urban communities within the United States.Conclusions Lower serum albumin levels were associated strongly with kidney function decline and incident reduced eGFRs in HIV-infected women independent of HIV disease status, body mass index, and albuminuria.

KW - Albumin

KW - albuminuria

KW - chronic kidney disease (CKD) progression

KW - disease trajectory

KW - HIV (human immunodeficiency virus)

KW - incident reduced estimated glomerular filtration rate (eGFR)

KW - kidney function

UR - http://www.scopus.com/inward/record.url?scp=84908145291&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84908145291&partnerID=8YFLogxK

U2 - 10.1053/j.ajkd.2014.05.015

DO - 10.1053/j.ajkd.2014.05.015

M3 - Article

C2 - 25059222

AN - SCOPUS:84908145291

VL - 64

SP - 584

EP - 591

JO - American Journal of Kidney Diseases

JF - American Journal of Kidney Diseases

SN - 0272-6386

IS - 4

ER -