Related Experiment Video

Updated: Jan 19, 2026

Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
05:53

Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty

Published on: July 24, 2013

17.0K

Associations of Urine Biomarkers with Kidney Function Decline in HIV-Infected and Uninfected Men

Simon B Ascher1,2, Rebecca Scherzer1, Michelle M Estrella1

  • 1Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Medical Center and University of California, San Francisco, California, USA.

American Journal of Nephrology
|September 26, 2019
PubMed

Insights

HIV-infected individuals show faster kidney function decline. Urine albumin and alpha-1-microglobulin predict worsening kidney function in HIV+ men, independent of estimated glomerular filtration rate.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Biomarker Discovery

Background:

  • Individuals with HIV are at higher risk for chronic kidney disease.
  • Serum creatinine is insufficient for detecting early kidney function decline in HIV+ persons.
  • Urine biomarkers may offer earlier detection of kidney damage.

Purpose of the Study:

  • To investigate the association between urine biomarkers of kidney damage and subsequent kidney function changes in HIV-infected (HIV+) and HIV-uninfected (HIV-) men.
  • To identify predictive urine biomarkers for kidney function decline in a contemporary cohort.

Main Methods:

  • Baseline urine concentrations of albumin, alpha-1-microglobulin (α1m), interleukin-18 (IL-18), kidney injury molecule-1 (KIM-1), and procollagen type III N-terminal propeptide (PIIINP) were measured.
  • Participants included 860 HIV+ and 337 HIV- men from the Multicenter AIDS Cohort Study (2009-2011).
  • Associations with annual changes in estimated glomerular filtration rate (eGFR) were analyzed using multivariable linear mixed models.

Main Results:

  • Over a median of 4.8 years, HIV+ men experienced an average annual eGFR decline of 1.42 mL/min/1.73 m²/year, compared to 1.22 mL/min/1.73 m²/year in HIV- men.
  • In HIV+ men, higher tertiles of urine albumin and α1m were associated with faster eGFR decline.
  • In HIV- men, higher α1m was independently associated with faster eGFR decline; IL-18, KIM-1, and PIIINP showed no significant associations.

Conclusions:

  • Elevated urine albumin and α1m levels are associated with accelerated kidney function decline in HIV+ men, independent of baseline eGFR.
  • These urine biomarkers may serve as early indicators of progressive kidney damage in the context of HIV infection.
  • Further research is warranted to explore the clinical utility of these biomarkers in managing kidney health in HIV-positive populations.
Abstract

Keywords:
AlbuminuriaAlpha-1-microglobulinHIVKidney damageUrine biomarker

More Related Videos

Unilateral Ureteral Obstruction Model for Investigating Kidney Interstitial Fibrosis04:37

Unilateral Ureteral Obstruction Model for Investigating Kidney Interstitial Fibrosis

Published on: April 25, 2025

1.4K
Establishment of the Dual Humanized TK-NOG Mouse Model for HIV-associated Liver Pathogenesis10:12

Establishment of the Dual Humanized TK-NOG Mouse Model for HIV-associated Liver Pathogenesis

Published on: September 11, 2019

9.1K

Related Concept Videos

Serum Studies: Renal Function Tests01:24

Serum Studies: Renal Function Tests

Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.
368
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
428
Nursing Assessment of the Genitourinary System I: Health History01:21

Nursing Assessment of the Genitourinary System I: Health History

The genitourinary system is critical to maintaining fluid balance, waste elimination, and reproductive function. Nurses play a vital role in assessing this system, beginning with a thorough health history. This process involves gathering patient information, identifying risk factors, and recognizing symptoms of genitourinary disorders. Early detection is vital for timely interventions and management.1. Gathering Patient InformationA complete health history includes the patient’s personal,...
376
Urine Studies I: Urinalysis01:29

Urine Studies I: Urinalysis

Urinalysis is a widely used diagnostic test that analyzes urine's physical, chemical, and microscopic characteristics. Healthcare providers use it to detect and monitor various health conditions, including renal disease, urinary tract infections (UTIs), diabetes, and metabolic or systemic disorders.Components of UrinalysisUrinalysis consists of three primary components: physical, chemical, and microscopic examination. Each provides unique insights into the urine sample and, by extension, the...
1.2K
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
271
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
238