# Impact of early antiretroviral therapy on kidney disease outcomes

> **NIH NIH R01** · DUKE UNIVERSITY · 2021 · $312,487

## Abstract

Project Abstract
HIV infection is associated with an increased risk of chronic kidney disease (CKD). Little is known about the
contribution of HIV and antiretroviral therapy (ART) to CKD in asymptomatic HIV. We hypothesize that
immediate initiation of ART in patients with high CD4+ cell counts will result in early improvements in
clinically relevant markers of CKD, but that the early renal benefits will be partially offset by prolonged
exposure to current first-line ART regimens with established nephrotoxic potential. We will test this
hypothesis in an ancillary study to the Strategic Timing of AntiRetroviral Treatment (START) trial, a
randomized trial investigating the impact of early versus deferred ART in treatment-naïve individuals with
CD4 > 500 cells/mm3. The randomized design of START offers a unique opportunity to directly compare the
change in kidney function and markers of kidney injury between HIV-infected individuals who initiate ART
immediately at high CD4 and similar individuals in whom ART is deferred. The prospective documentation
of estimated glomerular filtration rate and availability of archived plasma and urine specimens will allow us
to evaluate the impact of immediate ART on clinically relevant CKD outcomes and to refine existing risk
scores for the prediction of CKD in HIV-positive individuals with high CD4.

## Key facts

- **NIH application ID:** 10227168
- **Project number:** 5R01DK112258-05
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** CHRISTINA M WYATT
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $312,487
- **Award type:** 5
- **Project period:** 2018-07-01 → 2024-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10227168

## Citation

> US National Institutes of Health, RePORTER application 10227168, Impact of early antiretroviral therapy on kidney disease outcomes (5R01DK112258-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10227168. Licensed CC0.

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