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

Anthony N. Muiru, Michael G. Shlipak, Rebecca Scherzer, William R. Zhang, Simon B. Ascher, Vasantha Jotwani, Carl Grunfeld, Chirag R. Parikh, Derek Ng, Frank J. Palella, Ken Ho, Seble Kassaye, Anjali Sharma, Mardge Cohen, Ruibin Wang, Qibin Qi, Michelle M. Estrella

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: HIV-positive persons bear an excess burden of chronic kidney disease (CKD); however, conventional methods to assess kidney health are insensitive and non-specific for detecting early kidney injury. Urinary biomarkers can detect early kidney injury, and may help mitigate the risk of overt CKD. Methods: Cross-sectional study of HIV-positive persons in the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study. We measured levels of 14 biomarkers, capturing multiple dimensions of kidney injury. We then evaluated associations of known CKD risk factors with urine biomarkers using separate multivariable adjusted models for each biomarker. Results: Of the 198 participants, one third were on HAART and virally suppressed. The vast majority (95%) had preserved kidney function as assessed by serum creatinine, with a median eGFR of 103 ml/min/1.73 m2 (interquartile range (IQR): 88, 116). In our multivariable analyses, the associations of each CKD risk factor with urinary biomarker levels varied in magnitude. For example, HIV viral load was predominantly associated with elevations in interleukin(IL)-18, and albuminuria, while higher CD4 levels were associated with lower monocyte chemoattractant protein-1 (MCP-1) and β2-microglobulin. In contrast, older age was significantly associated with elevations in α1-microglobulin, kidney injury marker-1, clusterin, MCP-1, and chitinase-3-like protein-1 levels, as well as lower epidermal growth factor, and uromodulin levels. Conclusions: Among HIV-positive persons, CKD risk factors are associated with unique and heterogeneous patterns of changes in urine biomarkers levels. Additional work is needed to develop parsimonious algorithms that integrate multiple biomarkers and clinical data to discern the risk of overt CKD and its progression.

Original languageEnglish (US)
Article number4
JournalBMC Nephrology
Volume20
Issue number1
DOIs
StatePublished - Jan 3 2019

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Kidney Diseases
Chronic Renal Insufficiency
Cross-Sectional Studies
Biomarkers
HIV
Urine
Kidney
Chemokine CCL2
Wounds and Injuries
Chemokine CCL8
Uromodulin
Clusterin
Interleukin-18
Albuminuria
Highly Active Antiretroviral Therapy
Viral Load
Epidermal Growth Factor
Disease Progression
Creatinine
Acquired Immunodeficiency Syndrome

Keywords

  • HIV infection
  • Kidney injury
  • Multicenter AIDS cohort study (MACS)
  • Urine biomarkers
  • Women's interagency HIV study (WIHS)

ASJC Scopus subject areas

  • Nephrology

Cite this

Muiru, A. N., Shlipak, M. G., Scherzer, R., Zhang, W. R., Ascher, S. B., Jotwani, V., ... Estrella, M. M. (2019). Kidney disease risk factors associate with urine biomarkers concentrations in HIV-positive persons; A cross-sectional study. BMC Nephrology, 20(1), [4]. https://doi.org/10.1186/s12882-018-1192-y

Kidney disease risk factors associate with urine biomarkers concentrations in HIV-positive persons; A cross-sectional study. / Muiru, Anthony N.; Shlipak, Michael G.; Scherzer, Rebecca; Zhang, William R.; Ascher, Simon B.; Jotwani, Vasantha; Grunfeld, Carl; Parikh, Chirag R.; Ng, Derek; Palella, Frank J.; Ho, Ken; Kassaye, Seble; Sharma, Anjali; Cohen, Mardge; Wang, Ruibin; Qi, Qibin; Estrella, Michelle M.

In: BMC Nephrology, Vol. 20, No. 1, 4, 03.01.2019.

Research output: Contribution to journalArticle

Muiru, AN, Shlipak, MG, Scherzer, R, Zhang, WR, Ascher, SB, Jotwani, V, Grunfeld, C, Parikh, CR, Ng, D, Palella, FJ, Ho, K, Kassaye, S, Sharma, A, Cohen, M, Wang, R, Qi, Q & Estrella, MM 2019, 'Kidney disease risk factors associate with urine biomarkers concentrations in HIV-positive persons; A cross-sectional study', BMC Nephrology, vol. 20, no. 1, 4. https://doi.org/10.1186/s12882-018-1192-y
Muiru, Anthony N. ; Shlipak, Michael G. ; Scherzer, Rebecca ; Zhang, William R. ; Ascher, Simon B. ; Jotwani, Vasantha ; Grunfeld, Carl ; Parikh, Chirag R. ; Ng, Derek ; Palella, Frank J. ; Ho, Ken ; Kassaye, Seble ; Sharma, Anjali ; Cohen, Mardge ; Wang, Ruibin ; Qi, Qibin ; Estrella, Michelle M. / Kidney disease risk factors associate with urine biomarkers concentrations in HIV-positive persons; A cross-sectional study. In: BMC Nephrology. 2019 ; Vol. 20, No. 1.
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AU - Muiru, Anthony N.

AU - Shlipak, Michael G.

AU - Scherzer, Rebecca

AU - Zhang, William R.

AU - Ascher, Simon B.

AU - Jotwani, Vasantha

AU - Grunfeld, Carl

AU - Parikh, Chirag R.

AU - Ng, Derek

AU - Palella, Frank J.

AU - Ho, Ken

AU - Kassaye, Seble

AU - Sharma, Anjali

AU - Cohen, Mardge

AU - Wang, Ruibin

AU - Qi, Qibin

AU - Estrella, Michelle M.

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