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Published on: September 11, 2019
Microalbuminuria in HIV infection
Lynda Anne Szczech1, Carl Grunfeld, Rebecca Scherzer
1Duke University Medical Center, Department of Medicine, Division of Nephrology, Durham, North Carolina, USA.
AIDS (London, England)
|April 26, 2007
Summary
HIV infection significantly increases the risk of microalbuminuria, a marker for cardiovascular and kidney disease. This association is independent of other risk factors and warrants further investigation in HIV patients.
Area of Science:
- Nephrology
- Infectious Diseases
- Cardiology
Background:
- Microalbuminuria is a known risk factor for cardiovascular disease and mortality.
- The relationship between HIV infection and microalbuminuria requires further elucidation.
Purpose of the Study:
- To determine if HIV infection is an independent risk factor for microalbuminuria.
- To assess the association between HIV and microalbuminuria.
Main Methods:
- A cross-sectional study design was employed.
- Subjects from the "Fat Redistribution and Metabolic Change in HIV Infection" study, including HIV-positive and control individuals, were analyzed.
- Participants with proteinuria (dipstick ≥ 1+) were excluded.
Main Results:
- Microalbuminuria (urinary albumin/creatinine ratio, ACR > 30 mg/g) was significantly more prevalent in HIV-infected individuals (11%) compared to controls (2%) (P < 0.001).
- HIV infection remained a fivefold independent risk factor for microalbuminuria after multivariate adjustment (OR, 5.11; 95% CI, 1.97-13.31; P=0.0008).
- Insulin resistance, elevated systolic blood pressure, and a family history of hypertension were associated with higher ACR in HIV participants. Higher CD4 cell counts correlated with lower ACR.
Conclusions:
- HIV infection is strongly and independently associated with microalbuminuria.
- The severity of microalbuminuria in HIV-infected individuals is influenced by markers of insulin resistance, hypertension, and advanced HIV infection.
- The increased prevalence of microalbuminuria in HIV infection may indicate a heightened risk for future cardiovascular and kidney diseases, necessitating further research.
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