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Kidney disease risk factors associate with urine biomarkers concentrations in HIV-positive persons; a cross-sectional

Anthony N Muiru1, Michael G Shlipak2,3, Rebecca Scherzer2

  • 1Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Medical Center and University of California, 533 Parnassus Avenue, U404, Box 0532, San Francisco, CA, 94143, USA. Anthony.muiru@ucsf.edu.

BMC Nephrology
|January 5, 2019
PubMed

Insights

HIV-positive individuals show varied urinary biomarker changes linked to chronic kidney disease (CKD) risk factors. These unique patterns highlight the need for integrated biomarker approaches to predict CKD progression.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Biomarker Discovery

Background:

  • HIV-positive individuals have a higher risk of chronic kidney disease (CKD).
  • Current methods for assessing kidney health in HIV are insufficient for early detection of kidney injury.
  • Urinary biomarkers offer a promising avenue for early detection and management of kidney damage.

Purpose of the Study:

  • To investigate the associations between known CKD risk factors and specific urinary biomarkers in HIV-positive individuals.
  • To explore the heterogeneity of kidney injury patterns in this population.

Main Methods:

  • A cross-sectional study was conducted involving HIV-positive participants from the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study.
  • Levels of 14 urinary biomarkers were measured to assess various dimensions of kidney injury.
  • Multivariable regression models were used to evaluate associations between CKD risk factors and biomarker levels.

Main Results:

  • While most participants had preserved kidney function (median eGFR 103 ml/min/1.73 m²), distinct patterns emerged.
  • HIV viral load correlated with elevated interleukin-18 and albuminuria.
  • Older age was associated with increased levels of several kidney injury markers (e.g., α1-microglobulin, KIM-1, MCP-1) and decreased levels of others (e.g., EGF, uromodulin).

Conclusions:

  • CKD risk factors are linked to unique and diverse changes in urinary biomarker profiles among HIV-positive individuals.
  • Further research is required to develop algorithms integrating multiple biomarkers and clinical data for predicting CKD risk and progression.
Abstract

Keywords:
HIV infectionKidney injuryMulticenter AIDS cohort study (MACS)Urine biomarkersWomen’s interagency HIV study (WIHS)

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