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Microalbuminuria in HIV disease
Colleen Hadigan1, Elizabeth Edwards, Alice Rosenberg
1Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health (NIH), Department of Critical Care Medicine, NIH, Bethesda, MD, USA.
American Journal of Nephrology
|April 26, 2013
Summary
Microalbuminuria, a marker for kidney disease and cardiovascular risk, affects 14% of HIV patients. A single normal urine test reliably rules out this condition, but elevated results need confirmation.
Area of Science:
- Nephrology
- Infectious Diseases
- Cardiovascular Medicine
Background:
- Microalbuminuria indicates early kidney disease and cardiovascular risk.
- Assessing microalbuminuria prevalence and predictors in HIV-infected populations is crucial.
Purpose of the Study:
- Determine microalbuminuria prevalence in HIV patients.
- Evaluate the predictive value of a single urine albumin/creatinine ratio (ACR).
- Identify covariates associated with microalbuminuria.
Main Methods:
- Prospective cohort study of 182 HIV-infected subjects without proteinuria, elevated creatinine, diabetes, or chronic inflammatory conditions.
- Three research visits within 9 months.
- Microalbuminuria defined by specific ACR ranges for females and males.
Main Results:
- Prevalence of microalbuminuria was 14%.
- Negative predictive value of a single ACR was 98%; positive predictive value was 74%.
- Microalbuminuria associated with hypertension, metabolic syndrome, and CD4 count <200 cells/microl.
Conclusions:
- Microalbuminuria prevalence in HIV patients is similar to previous reports.
- Associated with hypertension and impaired immune function.
- A single normal ACR effectively excludes microalbuminuria; elevated ACR requires confirmation.
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