Dataset Information

Association of urine ?1-microglobulin with kidney function decline and mortality in HIV-infected women.

ABSTRACT:

Background and objectives

Despite advances in therapy, HIV-infected individuals remain at higher risk for kidney dysfunction than uninfected individuals. It was hypothesized that urine levels of ?1-microglobulin, a biomarker of proximal tubular dysfunction, would predict kidney function decline and mortality risk in HIV-infected and uninfected women.

Design, setting, participants, & measurements

In the Women's Interagency HIV Study, urine ?1-microglobulin and creatinine concentrations were measured in 903 HIV-infected and 287 uninfected women using stored urine from 1999 to 2000, when prevalence of tenofovir use was <1%. Participants were categorized into three categories by level of ?1-microglobulin-to-creatinine ratio, and associations with kidney decline and all-cause mortality over 8 years were evaluated.

Results

Urine ?1-microglobulin was detectable in 60% of HIV-infected and 40% of uninfected women (P<0.001). Among HIV-infected women, there were 177 (22%), 61 (7%), and 128 (14%) patients with incident CKD, with 10% annual eGFR decline, and who died, respectively. Compared with HIV-infected women in the lowest ?1-microglobulin category, HIV-infected women in the highest ?1-microglobulin category had a 2.1-fold risk of incident CKD (95% confidence interval, 1.3 to 3.4), 2.7-fold risk of 10% annual eGFR decline (95% confidence interval, 1.2 to 5.9), and 1.6-fold mortality risk (95% confidence interval, 1.0 to 2.6) in models adjusting for kidney risk factors, baseline eGFR, and albuminuria. Among uninfected women, the highest ?1-microglobulin category was associated with 3% (relative risk, 2.2; 95% confidence interval, 1.4 to 3.5) and 5% (relative risk, 2.2; 95% confidence interval, 1.1 to 4.3) annual eGFR decline relative to the lowest ?1-microglobulin category.

Conclusions

Proximal tubular dysfunction, indicated by urine ?1-microglobulin, was independently associated with kidney function decline in HIV-infected and uninfected women and mortality risk among HIV-infected women.

SUBMITTER: Jotwani V

PROVIDER: S-EPMC4284407 | biostudies-literature | 2015 Jan

REPOSITORIES: biostudies-literature

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Publications

Association of urine α1-microglobulin with kidney function decline and mortality in HIV-infected women.

Jotwani Vasantha V Scherzer Rebecca R Abraham Alison A Estrella Michelle M MM Bennett Michael M Cohen Mardge H MH Nowicki Marek M Sharma Anjali A Young Mary M Tien Phyllis C PC Ix Joachim H JH Sarnak Mark J MJ Parikh Chirag R CR Shlipak Michael G MG

Clinical journal of the American Society of Nephrology : CJASN 20141104 1

<h4>Background and objectives</h4>Despite advances in therapy, HIV-infected individuals remain at higher risk for kidney dysfunction than uninfected individuals. It was hypothesized that urine levels of α1-microglobulin, a biomarker of proximal tubular dysfunction, would predict kidney function decline and mortality risk in HIV-infected and uninfected women.<h4>Design, setting, participants, & measurements</h4>In the Women's Interagency HIV Study, urine α1-microglobulin and creatinine concentrat ...[more]

PMID: 25370597

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