Kidney Impairment Strongly Related to Heart Disease Risk in People With HIV

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Researchers call for greater heart disease monitoring and prevention in those with low kidney function.

August 26, 2016

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Low kidney function among people with HIV is strongly associated with an increased risk of cardiovascular disease (CVD), aidsmap reports. Part of this risk is tied to simply getting older, but aging doesn’t explain all the risk.

Publishing their findings in the Journal of Infectious Diseases, researchers from the ongoing Data Collection on Adverse events of Anti-HIV Drugs (D:A:D) study conducted a substudy looking at the connection between kidney function and heart disease. The D:A:D includes 11 large cohorts of people with HIV in the United States, Europe and Australia who are observed over time.

This substudy included 35,357 people living with HIV who between 2004 and 2015 had at least two estimated glomerular filtration rate (eGFR) tests, the results of which are an indication of kidney function. The study defined cardiovascular disease as having a heart attack, stroke, invasive cardiovascular procedures or heart-related sudden death.

The participants were followed for a median eight years. During that time, 1,357 of the participants experienced cardiovascular disease, for an annual rate of 0.52 percent.

The researchers found a strong connection between the participants’ first eGFR test result and the development of cardiovascular disease. They estimated that 1.8 percent of those with an eGFR of greater than 90 milliliters per minute per 1.7 square meters would develop cardiovascular disease within five years, a proportion that increased to 21.1 percent among those with eGFR less than 30 ml/min/1.73 m^2.

After controlling the data for the participants’ age, the researchers found that getting older accounted for some of the increased risk of cardiovascular disease; nevertheless, the link between low kidney function and heart disease remained strong. For those with an eGFR of less than 80 ml/min/1.73 m^2, the risk of cardiovascular disease increases by an estimated 30 to 40 percent compared with those with greater kidney function. And for those with an eGFR of less than 30 mil/min/1.73 m^2, there is an estimated 3.08-fold increased risk of cardiovascular disease.

The study authors concluded: “This finding highlights the need for [kidney] preventive measures and intensified monitoring for emerging [heart disease], in particular in older individuals with continuously low eGFR.”

To read the aidsmap article, click here.
To read the study abstract, click here.
Read more articles from POZ, here.