- Chronic kidney disease (CKD) risk factors are associated with a unique pattern of changes in urinary biomarker levels in patients with HIV.
Why this matters
- HIV is associated with an excess burden of CKD.
- Findings suggest potential utility of routinely measuring urinary biomarkers for early detection of renal injury.
- Data for 198 adults with HIV participating in 2 prospective observational studies: Multicenter AIDS Cohort Study (MACS) and the Women’s Interagency HIV Study (WIHS).
- Mean age, 48 years; 56% were female and 64% were black.
- 29% were virally suppressed on highly active antiretroviral therapy (HAART).
- Median estimated glomerular filtration rate, 103 mL/minute/1.73 m2.
- 14 urine biomarkers were evaluated for associations with known CKD risk factors.
- Funding: None disclosed.
- In multivariable analysis, HIV viral load was primarily associated with elevations in interleukin (IL)-18 and albuminuria.
- Higher CD4 levels were tied to lower monocyte chemoattractant protein-1 (MCP-1) and β2-microglobulin.
- Older age was significantly associated with nearly all dimensions of kidney injury:
- Elevations in α1-microglobulin, kidney injury marker (KIM)-1, clusterin, MCP-1, and chitinase-3-like protein-1 (YKL-40) levels.
- Lower epidermal growth factor and uromodulin levels.
- Cross-sectional design.
- Patients taking tenofovir disoproxil fumarate excluded.
- Not confirmed by kidney biopsy.