NYMC Faculty Publications

Association of Marijuana, Tobacco and Alcohol Use With Estimated Glomerular Filtration Rate in Women Living With HIV and Women Without HIV


Molly C. Fisher, Division of Nephrology, Albert Einstein College of Medicine, Bronx, New York.
Donald R. Hoover, Department of Statistics and Institute for Health, Healthcare Policy and Aging Research, Rutgers University, Piscataway, New Jersey.
Qiuhu Shi, Department of Public Health, New York Medical College, Valhalla.
Anjali Sharma, Division of Infectious Diseases, Albert Einstein College of Medicine, Bronx, New York.
Michelle M. Estrella, Division of Nephrology and Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center and University of California, San Francisco, California.
Adaora Adimora, Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Maria Alcaide, University of Miami Miller School of Medicine, Miami, Florida.
Lauren F. Collins, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia.
Audrey French, Stroger Hospital of Cook County, Chicago, Illinois.
Wei Gao
Susan L. Koletar, Division of Infectious Diseases, College of Medicine, The Ohio State University, Columbus, Ohio.
Samy I. Mcfarlane, State University of New York, Downstate Health Science University, Brooklyn, New York.
Heather Mckay, Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Jodie A. Dionne, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
Frank Palella, Department of Medicine, Northwestern University, Chicago, Illinois.
Sudipa Sarkar, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Amanda Spence, Department of Medicine, Division of Infectious Disease and Tropical Medicine, Georgetown University, Washington, DC.
Mallory D. Witt, Lundquist Research Institute at Harbor, UCLA Medical Center, Torrance, California, USA.
Michael J. Ross, Division of Nephrology, Albert Einstein College of Medicine, Bronx, New York.

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Public Health


OBJECTIVE: Marijuana, tobacco and alcohol use are prevalent among people with HIV and may adversely affect kidney function in this population. We determined the association of use of these substances with estimated glomerular filtration rate (eGFR) among women with HIV (WWH) and women without HIV. DESIGN: We undertook a repeated measures study of 1043 WWH and 469 women without HIV within the United States Women's Interagency HIV Study, a multicenter, prospective cohort of HIV-seropositive and HIV-seronegative women. METHODS: We quantified substance exposures using semi-annual questionnaires. Using pooled eGFR data from 2009 to 2019, we used linear regression models with multivariable generalized estimating equations to ascertain associations between current and cumulative substance use exposures with eGFR, adjusting for sociodemographics, chronic kidney disease risk factors and HIV-related factors. RESULTS: Marijuana use of 1-14 days/month versus 0 days/month was associated with 3.34 ml/min per 1.73 m 2 [95% confidence interval (CI) -6.63, -0.06] lower eGFR and marijuana use of >0.02-1.6 marijuana-years versus 0-0.2 marijuana-years was associated with 3.61 ml/min per 1.73 m 2 (95% CI -5.97, -1.24) lower eGFR. Tobacco use was not independently associated with eGFR. Alcohol use of seven or more drinks/week versus no drinks/week was associated with 5.41 ml/min per 1.73 m 2 (95% CI 2.34, 8.48) higher eGFR and alcohol use of >0.7-4.27 drink-years and >4.27 drink-years versus 0-0.7 drink-years were associated with 2.85 ml/min per 1.73 m 2 (95% CI 0.55, 5.15) and 2.26 ml/min per 1.73 m 2 (95% CI 0.33, 4.20) higher eGFR, respectively. CONCLUSION: Among a large cohort of WWH and women without HIV, marijuana use was associated with a lower eGFR while alcohol use was associated with a higher eGFR.