Document Detail


Urinary markers of kidney injury and kidney function decline in HIV-infected women.
MedLine Citation:
PMID:  23023103     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: HIV-infected persons have substantially higher risk of kidney failure than persons without HIV, but serum creatinine levels are insensitive for detecting declining kidney function. We hypothesized that urine markers of kidney injury would be associated with declining kidney function among HIV-infected women.
METHODS: In the Women's Interagency HIV Study, we measured concentrations of albumin-to-creatinine ratio, interleukin-18 (IL-18), kidney injury marker-1 (KIM-1), and neutrophil gelatinase-associated lipocalin from stored urine among 908 HIV-infected and 289 HIV-uninfected participants. Primary analyses used cystatin C-based estimated glomerular filtration rate (CKD-EPI eGFRcys) as the outcome, measured at baseline and 2 follow-up visits over 8 years; secondary analyses used creatinine (CKD-EPI eGFRcr). Each urine biomarker was categorized into tertiles, and kidney decline was modeled with both continuous and dichotomized outcomes.
RESULTS: Compared with the lowest tertiles, the highest tertiles of albumin-to-creatinine ratio (-0.15 mL/min per 1.73 m, P < 0.0001), IL-18 (-0.09 mL/min per 1.73 m, P < 0.0001) and KIM-1 (-0.06 mL/min per 1.73 m, P < 0.001) were independently associated with faster eGFRcys decline after multivariate adjustment including all 3 biomarkers among HIV-infected women. Among these biomarkers, only IL-18 was associated with each dichotomized eGFRcys outcome: ≥3% (relative risk = 1.40; 95% confidence interval: 1.04 to 1.89); ≥5% (1.88; 1.30 to 2.71); and ≥10% (2.16; 1.20 to 3.88) for the highest versus lowest tertile. In alternative models using eGFRcr, the high tertile of KIM-1 had independent associations with 5% (1.71; 1.25 to 2.33) and 10% (1.78; 1.07 to 2.96) decline, and the high IL-18 tertile with 10% decline (1.97; 1.00 to 3.87).
CONCLUSIONS: Among HIV-infected women in the Women's Interagency HIV Study cohort, novel urine markers of kidney injury detect risk for subsequent declines in kidney function.
Authors:
Michael G Shlipak; Rebecca Scherzer; Alison Abraham; Phyllis C Tien; Carl Grunfeld; Carmen A Peralta; Prasad Devarajan; Michael Bennett; Anthony W Butch; Kathryn Anastos; Mardge H Cohen; Marek Nowicki; Anjali Sharma; Mary A Young; Mark J Sarnak; Chirag R Parikh
Related Documents :
19009653 - Chronic hepatitis c is a common associated with hepatic granulomas.
24464523 - Antiretroviral therapy is not associated with reduced herpes simplex virus shedding in ...
14522063 - Quality control measures for the serological diagnosis of hantavirus infections.
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  61     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-28     Completed Date:  2013-02-04     Revised Date:  2013-12-18    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  565-73     Citation Subset:  IM; X    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
AIDS-Associated Nephropathy / etiology,  physiopathology*,  urine*
Acute-Phase Proteins / urine
Adult
Albuminuria / urine
Biological Markers / urine
Case-Control Studies
Creatinine / urine
Disease Progression
Female
Glomerular Filtration Rate
HIV Infections / physiopathology*,  urine*
Humans
Interleukin-18 / urine
Kidney / injuries*,  physiopathology*
Lipocalins / urine
Membrane Glycoproteins / urine
Middle Aged
Proto-Oncogene Proteins / urine
Receptors, Virus
Risk Factors
Grant Support
ID/Acronym/Agency:
1R01AG034853-01A2/AG/NIA NIH HHS; K23 AR061993/AR/NIAMS NIH HHS; K24 DK090203/DK/NIDDK NIH HHS; P50 DK096418/DK/NIDDK NIH HHS; R01 AG034853/AG/NIA NIH HHS; U01 AI031834/AI/NIAID NIH HHS; U01 AI034994/AI/NIAID NIH HHS; U01 AI035004/AI/NIAID NIH HHS; UL1 RR024131/RR/NCRR NIH HHS; UO1-AI-31834/AI/NIAID NIH HHS; UO1-AI-34989/AI/NIAID NIH HHS; UO1-AI-34993/AI/NIAID NIH HHS; UO1-AI-34994/AI/NIAID NIH HHS; UO1-AI-35004/AI/NIAID NIH HHS; UO1-AI-4259/AI/NIAID NIH HHS; UO1-HD-32632/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Acute-Phase Proteins; 0/Biological Markers; 0/HAVCR1 protein, human; 0/Interleukin-18; 0/LCN2 protein, human; 0/Lipocalins; 0/Membrane Glycoproteins; 0/Proto-Oncogene Proteins; 0/Receptors, Virus; AYI8EX34EU/Creatinine
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Anti-CD4 Monoclonal Antibody Ibalizumab Exhibits Breadth and Potency against HIV-1, with Natural Res...
Next Document:  Identification and Characterization of Novel Human Glucose-6-Phosphate Dehydrogenase Inhibitors.