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PLoS One. 2014 Feb 7;9(2):e86311. doi: 10.1371/journal.pone.0086311. eCollection 2014.

Factors affecting glomerular filtration rate, as measured by iohexol disappearance, in men with or at risk for HIV infection.

Author information

  • 1Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
  • 2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
  • 3Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, United States of America.
  • 4Department of Infectious Diseases and Microbiology and Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.
  • 5Department of Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, United States of America ; Los Angeles Biomedical Research Institute at Harbor-UCLA, University of California Los Angeles, Los Angeles, California, United States of America.
  • 6Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America.

Abstract

OBJECTIVE:

Formulae used to estimate glomerular filtration rate (GFR) underestimate higher GFRs and have not been well-studied in HIV-infected (HIV(+)) people; we evaluated the relationships of HIV infection and known or potential risk factors for kidney disease with directly measured GFR and the presence of chronic kidney disease (CKD).

DESIGN:

Cross-sectional measurement of iohexol-based GFR (iGFR) in HIV(+) men (n = 455) receiving antiretroviral therapy, and HIV-uninfected (HIV(-)) men (n = 258) in the Multicenter AIDS Cohort Study.

METHODS:

iGFR was calculated from disappearance of infused iohexol from plasma. Determinants of GFR and the presence of CKD were compared using iGFR and GFR estimated by the CKD-Epi equation (eGFR).

RESULTS:

Median iGFR was higher among HIV(+) than HIV(-) men (109 vs. 106 ml/min/1.73 m(2), respectively, p = .046), and was 7 ml/min higher than median eGFR. Mean iGFR was lower in men who were older, had chronic hepatitis C virus (HCV) infection, or had a history of AIDS. Low iGFR (≤90 ml/min/1.73 m(2)) was associated with these factors and with black race. Other than age, factors associated with low iGFR were not observed with low eGFR. CKD was more common in HIV(+) than HIV(-) men; predictors of CKD were similar using iGFR and eGFR.

CONCLUSIONS:

iGFR was higher than eGFR in this population of HIV-infected and -uninfected men who have sex with men. Presence of CKD was predicted equally well by iGFR and eGFR, but associations of chronic HCV infection and history of clinically-defined AIDS with mildly decreased GFR were seen only with iGFR.

PMID:
24516530
[PubMed - indexed for MEDLINE]
PMCID:
PMC3917840
Free PMC Article
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