HIV: CKD risk factors tied to urine biomarker patterns

  • Muiru AN & al.
  • BMC Nephrol
  • 3 Jan 2019

  • curated by Yael Waknine
  • Clinical Essentials
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • 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.

Study design

  • 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.  

Key results

  • 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.     

Limitations

  • Cross-sectional design.
  • Patients taking tenofovir disoproxil fumarate excluded.
  • Not confirmed by kidney biopsy.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit