Reduced Kidney Function and Preclinical Atherosclerosis in HIV-Infected Individuals: The Study of Fat Redistribution and Metabolic Change in HIV Infection (FRAM)

Background/Aims: Reduced kidney function and albuminuria are associated with higher risk for cardiovascular disease (CVD) and mortality in HIV-infected individuals. We investigated whether reduced estimated glomerular filtration rate (eGFR) and albuminuria are associated with subclinical vascular disease, as assessed by carotid intima-medial thickness (cIMT). Methods: Cross-sectional analysis of 476 HIV-infected individuals without clinical evidence of CVD enrolled in the Fat Redistribution and Metabolic Change in HIV infection (FRAM) study, using multivariable linear regression. eGFR Cys and eGFR Cr were calculated from cystatin C and creatinine levels. Albuminuria was defined as a positive urine dipstick ( 6 1+) or urine albumin-to-creatinine ratio 6 30 mg/g. Common and internal cIMT were measured by high-resolution B-mode ultrasound. Results: In unadjusted analyses, eGFR Cys and eGFR Cr were strongly associated with common and internal cIMT. Each 10 ml/min/1.73 m 2 decrease in eGFR Cys and eGFR cr was associated with a 0.008 mm higher