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Kidney Disease May Add to Higher Risk for CVD Due to HIV

FRIDAY, Dec. 18, 2020 -- Kidney function has a strong influence on the effect of HIV serostatus on brachial artery flow-mediated dilation (FMD), a measure of endothelial function, according to a study published online Dec. 17 in Arteriosclerosis, Thrombosis, and Vascular Biology.

James H. Stein, M.D., from the University of Wisconsin School of Medicine and Public Health in Madison, and colleagues examined the effects of HIV serostatus and disease severity on endothelial function in a pooled cohort study of people living with HIV infection (986 participants) and HIV-negative controls (1,547 individuals) from nine studies.

The researchers found that brachial artery diameter, age, sex, and body mass index were the strongest and most consistent associates of FMD. Kidney function had a strong influence on the effect of HIV+ serostatus on FMD. The effect of HIV+ serostatus was strong in the highest tertile of creatinine (ß = −1.59 percent) even after adjustment for covariates (ß = −1.36 percent). The effect of HIV+ serostatus was also strong in the lowest tertile of creatinine (ß = −1.90 percent), but after covariate adjustment, this finding was longer seen. No meaningful associations with FMD were seen for HIV RNA viremia, CD4+ T-cell count, or use of antiretroviral therapy.

"We also did not expect such a large effect from kidney function on HIV patients' endothelial health," Stein said in a statement. "Even mild kidney disease might play a role in HIV-associated cardiovascular disease risk."

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Posted: December 2020

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