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The association of adiposity with kidney function decline among HIV-infected adults: findings from the Fat Redistribution and Metabolic Changes in HIV Infection (FRAM) study.
HIV Med 2015; 16(3):184-90HM

Abstract

OBJECTIVES

The aim of the study was to investigate the association of adiposity with longitudinal kidney function change in 544 HIV-infected persons in the Study of Fat Redistribution and Metabolic Change in HIV infection (FRAM) cohort over 5 years of follow-up.

METHODS

The regional distribution of muscle and adipose tissue was quantified by whole-body magnetic resonance imaging (MRI), and total adiponectin and leptin levels were measured in serum. Kidney function was assessed using the estimated glomerular filtration rate from serum cystatin C (eGFRCys), obtained at baseline and follow-up. Rapid kidney function decline was defined as annual loss of eGFRCys ≥ 3 mL/min/1.73 m(2) , and incident chronic kidney disease (CKD) was defined as eGFRCys <60 mL/min/1.73 m(2) . Multivariate regression analysis was adjusted for age, race, gender, glucose, antihypertensive use, serum albumin, baseline and change in HIV viral load.

RESULTS

At baseline, mean age was 43 years, mean eGFRCys was 86 mL/min/1.73 m(2) , and 21% of patients had albuminuria. The mean (± standard deviation) eGFRCys decline was -0.11 ± 4.87 mL/min/1.73 m(2) per year; 23% of participants had rapid kidney function decline, and 10% developed incident CKD. The lowest tertile of visceral adipose tissue and the highest tertile of adiponectin were both marginally associated with annual kidney function decline of -0.5 mL/min/1.73 m(2) each, but these associations were not statistically significant after adjustment. We found no statistically significant associations of MRI-measured regional adiposity or serum adipokines with rapid kidney function decline or incident CKD (all P-values>0.1 in adjusted models).

CONCLUSIONS

Contrary to findings in the general population, adiposity did not have a substantial association with longitudinal change in kidney function among HIV-infected persons.

Authors+Show Affiliations

University of California San Francisco Division of Nephrology, San Francisco, CA, USA; Veterans Affairs Medical Center Department of Medicine, San Francisco, CA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

25251910

Citation

Malkina, A, et al. "The Association of Adiposity With Kidney Function Decline Among HIV-infected Adults: Findings From the Fat Redistribution and Metabolic Changes in HIV Infection (FRAM) Study." HIV Medicine, vol. 16, no. 3, 2015, pp. 184-90.
Malkina A, Scherzer R, Shlipak MG, et al. The association of adiposity with kidney function decline among HIV-infected adults: findings from the Fat Redistribution and Metabolic Changes in HIV Infection (FRAM) study. HIV Med. 2015;16(3):184-90.
Malkina, A., Scherzer, R., Shlipak, M. G., Bacchetti, P., Tien, P. C., Grunfeld, C., ... Peralta, C. A. (2015). The association of adiposity with kidney function decline among HIV-infected adults: findings from the Fat Redistribution and Metabolic Changes in HIV Infection (FRAM) study. HIV Medicine, 16(3), pp. 184-90. doi:10.1111/hiv.12196.
Malkina A, et al. The Association of Adiposity With Kidney Function Decline Among HIV-infected Adults: Findings From the Fat Redistribution and Metabolic Changes in HIV Infection (FRAM) Study. HIV Med. 2015;16(3):184-90. PubMed PMID: 25251910.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The association of adiposity with kidney function decline among HIV-infected adults: findings from the Fat Redistribution and Metabolic Changes in HIV Infection (FRAM) study. AU - Malkina,A, AU - Scherzer,R, AU - Shlipak,M G, AU - Bacchetti,P, AU - Tien,P C, AU - Grunfeld,C, AU - Kosmiski,L, AU - Peralta,C A, Y1 - 2014/09/23/ PY - 2014/07/22/accepted PY - 2014/9/25/entrez PY - 2014/9/25/pubmed PY - 2015/8/26/medline KW - Fat Redistribution and Metabolic Changes in HIV Infection (FRAM) KW - HIV KW - adiposity KW - kidney decline SP - 184 EP - 90 JF - HIV medicine JO - HIV Med. VL - 16 IS - 3 N2 - OBJECTIVES: The aim of the study was to investigate the association of adiposity with longitudinal kidney function change in 544 HIV-infected persons in the Study of Fat Redistribution and Metabolic Change in HIV infection (FRAM) cohort over 5 years of follow-up. METHODS: The regional distribution of muscle and adipose tissue was quantified by whole-body magnetic resonance imaging (MRI), and total adiponectin and leptin levels were measured in serum. Kidney function was assessed using the estimated glomerular filtration rate from serum cystatin C (eGFRCys), obtained at baseline and follow-up. Rapid kidney function decline was defined as annual loss of eGFRCys ≥ 3 mL/min/1.73 m(2) , and incident chronic kidney disease (CKD) was defined as eGFRCys <60 mL/min/1.73 m(2) . Multivariate regression analysis was adjusted for age, race, gender, glucose, antihypertensive use, serum albumin, baseline and change in HIV viral load. RESULTS: At baseline, mean age was 43 years, mean eGFRCys was 86 mL/min/1.73 m(2) , and 21% of patients had albuminuria. The mean (± standard deviation) eGFRCys decline was -0.11 ± 4.87 mL/min/1.73 m(2) per year; 23% of participants had rapid kidney function decline, and 10% developed incident CKD. The lowest tertile of visceral adipose tissue and the highest tertile of adiponectin were both marginally associated with annual kidney function decline of -0.5 mL/min/1.73 m(2) each, but these associations were not statistically significant after adjustment. We found no statistically significant associations of MRI-measured regional adiposity or serum adipokines with rapid kidney function decline or incident CKD (all P-values>0.1 in adjusted models). CONCLUSIONS: Contrary to findings in the general population, adiposity did not have a substantial association with longitudinal change in kidney function among HIV-infected persons. SN - 1468-1293 UR - https://www.unboundmedicine.com/medline/citation/25251910/The_association_of_adiposity_with_kidney_function_decline_among_HIV_infected_adults:_findings_from_the_Fat_Redistribution_and_Metabolic_Changes_in_HIV_Infection__FRAM__study_ L2 - https://doi.org/10.1111/hiv.12196 DB - PRIME DP - Unbound Medicine ER -