African American/black race, Apolipoprotein L1, and the indirect glomerular filtration measure serum creatinine among persons living with HIV
Brittany A. Shelton, Deirdre Sawinski, Inga Peter, Paul A. Maclennan, Nicole F. Pelletier, Girish Nadkarni, Bruce Julian, Michael Saag, Huma Fatima, Heidi Crane, Wonjun Lee, Richard D. Moore, Katerina Christopoulos, Jeffrey M. Jacobson, Joseph J. Eron, Vineeta Kumar, Jayme E. Locke- Infectious Diseases
- Immunology
- Immunology and Allergy
Objective:
Accurate estimation of kidney function is critical among people living with HIV (PLWH) to avoid under-dosing of antiretroviral therapies and ensure timely referral for kidney transplantation. Existing estimation equations for kidney function include race, the appropriateness of which has been debated. Given advancements in understanding of race and the necessity of accuracy in kidney function estimation, this study aimed to examine whether race, or genetic factors, improved prediction of serum creatinine among PLWH.
Design:
This cross-sectional study utilized data from the Center for AIDS Research Network of Integrated Clinical Systems cohort (2008–2018). The outcome was baseline serum creatinine.
Methods:
Ordinary least squares regression was used to examine whether inclusion of race or genetic factors (
Results:
There were 4,183 PLWH included. Among PLWH whose serum creatinine <1.7 mg/dL, race was significantly associated with serum creatinine (β = 0.06, SE = 0.01, p < 0.001), but did not improve predictive ability. African ancestry and
Conclusions:
These data suggest that, among PLWH, inclusion of race or genetic factors may only be warranted at higher serum creatinine levels. Work eliminating existing healthcare disparities while preserving the utility of estimating equations is needed.