The utility of kidney injury molecule-1 as an early biomarker of kidney injury in people living with HIV.

ABSTRACT: There are increasing reports of antiretroviral therapy (ART) drug-related kidney dysfunction. Traditional markers of kidney dysfunction such as urine protein/creatinine ratio and estimated glomerular filtration rate (eGFR) have thus far proven ineffective at detecting some sub-clinical forms of ART-related kidney injury. This is a cross-sectional examination of 114 people living with HIV (PLWH), either naïve (N =104) or treatment experienced (N =10). Urinary kidney injury molecule-1 (KIM-1 ng/mg) thresholds were estimated using electrochemiluminescent assays from stored urine samples and normalised for urinary creatinine excretion (KIM-1/Cr). Correlation coefficients and predictors of kidney tubular injury were compared and derived for both adjusted and unadjusted urinary KIM-1/CR (ng/mg). In PLWH (both ART-naïve and treatment experienced) had a higher baseline unadjusted and adjusted median (?3.7?ng/mg) and upper tertile (?6.25?ng/mg) urinary KIM-1/Cr levels compared to either non-normal volunteers (0.39?ng/mg) or those with acute kidney injury in the general population (0.57?ng/mg). When upper tertile KIM-1/Cr (?6.25?ng/mg) was utilised as a marker of kidney injury, eGFR (ml/min/1.73 m²), white Caucasian ethnicity, and protease inhibitor exposure were significantly associated with increased risk of kidney injury in multivariate analyses (odds ratio 0.91, confidence interval [CI] 0.68-0.98, P?=?0.02; odds ratio 8.9, CI 1.6-48.6, p?=?0.01; and odds ratio 0.05, CI 0.03-0.9, p =0.04, respectively). We found a significant degree of sub-clinical kidney injury (high unadjusted and adjusted KIM-1/Cr) in PLWH with normal kidney function (eGFR ?60 ml/min/1.73 m²). We also found a higher baseline KIM-1/Cr (ng/mg) in our study cohort than reported both in normal volunteers and patients with kidney injury in the general population.

SUBMITTER: Danjuma MI 

PROVIDER: S-EPMC7754827 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature