Genetic Variants of Are Major Determinants of Kidney Failure in People of African Ancestry With HIV

Overview

Journal Kidney Int Rep

Publisher Elsevier

Specialty Nephrology

Date 2022 May 2

PMID 35497797

Authors

Rachel K Y Hung

Elizabeth Binns-Roemer

John W Booth

Rachel Hilton

Mark Harber

Beatriz Santana-Suarez

Lucy Campbell

Julie Fox

Andrew Ustianowski

Catherine Cosgrove

James E Burns

Amanda Clarke

David A Price

David Chadwick

Denis Onyango

Lisa Hamzah

Kate Bramham

Caroline A Sabin

Cheryl A Winkler

Frank A Post

Affiliations

Soon will be listed here.

Abstract

Introduction: Variants of the gene are associated with chronic kidney disease (CKD) in people of African ancestry, although evidence for their impact in people with HIV are sparse.

Methods: We conducted a cross-sectional study investigating the association between renal risk alleles and kidney disease in people of African ancestry with HIV in the UK. The primary outcome was end-stage kidney disease (ESKD; estimated glomerular filtration rate [eGFR] of <15 ml/min per 1.73 m, chronic dialysis, or having received a kidney transplant). The secondary outcomes included renal impairment (eGFR <60 ml/min per 1.73 m), albuminuria (albumin-to-creatinine ratio [ACR] >30 mg/mmol), and biopsy-proven HIV-associated nephropathy (HIVAN). Multivariable logistic regression was used to estimate the associations between high-risk genotypes (G1/G1, G1/G2, G2/G2) and kidney disease outcomes.

Results: A total of 2864 participants (mean age 48.1 [SD 10.3], 57.3% female) were genotyped, of whom, 354 (12.4%) had high-risk genotypes, and 99 (3.5%) had ESKD. After adjusting for demographic, HIV, and renal risk factors, individuals with high-risk genotypes were at increased odds of ESKD (odds ratio [OR] 10.58, 95% CI 6.22-17.99), renal impairment (OR 5.50, 95% CI 3.81-7.95), albuminuria (OR 3.34, 95% CI 2.00-5.56), and HIVAN (OR 30.16, 95% CI 12.48-72.88). An estimated 49% of ESKD was attributable to high-risk genotypes.

Conclusion: high-risk genotypes were strongly associated with kidney disease in people of African ancestry with HIV and accounted for approximately half of ESKD cases in this cohort.

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