Kidney disease risk factors associate with urine biomarkers concentrations in HIV-positive persons; a cross-sectional study
Year: 2019
Type: article
Study design: Observational Study
Abstract: BACKGROUND: HIV-positive persons bear an excess burden of chronic kidney disease (CKD); however, conventional methods to assess kidney health are insensitive and non-specific for detecting early kidney injury. Urinary biomarkers can detect early kidney injury, and may help mitigate the risk of overt CKD. METHODS: Cross-sectional study of HIV-positive persons in the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study. We measured levels of 14 biomarkers, capturing multiple dimensions of kidney injury. We then evaluated associations of known CKD risk factors with urine biomarkers using separate multivariable adjusted models for each biomarker. RESULTS: (interquartile range (IQR): 88, 116). In our multivariable analyses, the associations of each CKD risk factor with urinary biomarker levels varied in magnitude. For example, HIV viral load was predominantly associated with elevations in interleukin(IL)-18, and albuminuria, while higher CD4 levels were associated with lower monocyte chemoattractant protein-1 (MCP-1) and β2-microglobulin. In contrast, older age was significantly associated with elevations in α1-microglobulin, kidney injury marker-1, clusterin, MCP-1, and chitinase-3-like protein-1 levels, as well as lower epidermal growth factor, and uromodulin levels. CONCLUSIONS: Among HIV-positive persons, CKD risk factors are associated with unique and heterogeneous patterns of changes in urine biomarkers levels. Additional work is needed to develop parsimonious algorithms that integrate multiple biomarkers and clinical data to discern the risk of overt CKD and its progression.
Source: BMC Nephrology
Institutions: San Francisco VA Medical Center, University of California, San Francisco, San Francisco VA Health Care System, University of California, Los Angeles, Yale University, Johns Hopkins University, Northwestern University, University of Pittsburgh, Georgetown University Medical Center, Albert Einstein College of Medicine, Rush University
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,170
Funders: U.S. Department of Veterans Affairs, Northwestern University, Johns Hopkins University, University of Pittsburgh, Northern California Institute for Research and Education, Georgia Clinical and Translational Science Alliance, National Institutes of Health, University of California, Los Angeles, University of California, San Francisco, Johns Hopkins Bloomberg School of Public Health, National Institute on Alcohol Abuse and Alcoholism, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Institute on Drug Abuse, National Cancer Institute, National Institute on Deafness and Other Communication Disorders, National Institute of Allergy and Infectious Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Child Health and Human Development, National Institute of Dental and Craniofacial Research, Office of Research on Women's Health, National Center for Advancing Translational Sciences, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Center for AIDS Research, University of North Carolina at Chapel Hill
Awards: G1089263533, G1110103167, G1111999087, G1114015694, G1166984944, G12089860, G1274611523, G1328638908, Center/Coordination, Analysis and Management/MACS, G1446261281, G1648857542, G1732606383, G1826418709, G1835874845, G2072110039, G2088232294, G2127051194, G216444255, G227110230, G2277270920, G2298971178, G2460023850, G2583540734, G259661504, G2639424016, G2640595981, G2764864546, G2840865780, G2876758893, G2986904770, G3001095189, G3013054560, G3089064904, G311558797, G3130478842, G3206421427, G3219051927, G3381142117, G3415611610, G3481933404, Miami Womens Interagency HIV Study WIHS, G3671922257, G3685536865, G3786813389, G3799046232, G3942807564, G4019075231, G403271778, Natural History of AIDS in Homosexual Men, G4166501182, G4205096527, G4230593884, G4263984760, G4333671923, G4361283536, G4371267688, G4500389830, G4558954805, G4698478974, G4763761376, G483408255, G489153995, Chicago WIHS Consortium V (CWC), G5162520385, G5411330681, G5411403494, G5502559727, G5634615262, G5641536491, G5652173662, G5653205272, G5655542889, G5657152656, G5659629669, G5873686156, G5900455136, G592158972, G5938652292, G604406090, G6068496172, G612407757, G6270227296, G6300780520, G6341392406, G6384504179, Institute for Clinical and Translational Research, G6533371250, G6576622550, G661928818, G669420692, Multicenter AIDS Cohort Study, G6937273202, G6944561475, G6990385686, G7000745727, University of North Carolina Womens Interagency HIV Study UNC WIHS, G7140729675, G7479905529, G7512160369, G767062161, G773494495, G775892330, G7807729167, G8039576609, G8327600025, G8448522485, G8846374971, UAB-MISS WIHS Cohort, G9000009364, G9000021013, G9000029981, G9000030772, G9000039899, G9000052758, G9000059706, G9000070603, G9000080293, G9000081039, G9000084207, G9000110076, G9000122276, G9000177630, G9000204903, G9000216739, Biomarker-Based Diagnostic Algorithms To Prevent, Detect And Guide Treatment Of Kidney Disease In Persons Living With HIV, Clinical Research Sites for the MACS/WIHS Combined Cohort Study (MACS/WIHS-CCS) - Baltimore/Wash DC Center, G901243891, G986692823
OpenAlex ID: W2909031886