Universität zu Köln

Gravemann, Sophia, Brinkkoetter, Paul T., Vehreschild, Joerg J., Franke, Bernd, Ehren, Kathrin, Buenemann, Elisabeth, Orbach, Henning, Weiss, Verena, Hellmich, Martin, Benzing, Thomas and Faetkenheuer, Gerd (2014). Low-grade proteinuria is highly prevalent in HIV-positive patients on antiretroviral treatment. Aids, 28 (12). S. 1783 - 1790. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1473-5571

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Abstract

Objectives: HIV-positive patients are at an increased risk for chronic kidney disease. However, these data mainly derive from cohorts with a high percentage of African-American patients, representing a specific ethnical risk group for chronic kidney disease. The aim of this study was to estimate the prevalence and risk factors specifically for early signs of kidney dysfunction in a large, predominantly white cohort of HIV patients. Design: Cross-sectional study. Methods: Prevalence of low-grade proteinuria was measured by quantitative analysis of urinary protein-to-creatinine ratio (cutoff >70mg/g) and further differentiated by assessing a1-microglobulin (tubular proteinuria) and albumin-to-creatinine ratio (glomerular proteinuria) of HIV patients attending the University Hospital in Cologne, Germany. Together with standard and HIV-related laboratory findings and medical history, risk factors for each form of proteinuria were identified using multivariate forward selection. Results: Of 945 enrolled patients, 55% were identified with low-grade proteinuria, 41% with tubular proteinuria, and 20% with glomerular proteinuria. Older age was a risk factor for all forms of proteinuria in multivariate analysis. Low-grade proteinuria was also associated with concomitant diabetes and exposure to nucleoside reverse transcriptase inhibitor [ anytime during HIV infection, not tenofovir (TDF)-specific], whereas tubular proteinuria was linked to current and any exposure to nucleoside reverse transcriptase inhibitor (TDF-specific). Further risk factors for glomerular proteinuria were hypertension and diabetes in this cohort. Conclusion: Low-grade, glomerular and tubular proteinuria are highly prevalent in this large white HIV cohort. Older age represents a nonmodifiable risk factor for all forms of proteinuria. Glomerular proteinuria is associated with modifiable cardiovascular, but not HIV-related risk factors, whereas tubular proteinuria is linked to TDF exposure. (C) 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Gravemann, Sophia UNSPECIFIED UNSPECIFIED UNSPECIFIED Brinkkoetter, Paul T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Joerg J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Franke, Bernd UNSPECIFIED UNSPECIFIED UNSPECIFIED Ehren, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Buenemann, Elisabeth UNSPECIFIED UNSPECIFIED UNSPECIFIED Orbach, Henning UNSPECIFIED UNSPECIFIED UNSPECIFIED Weiss, Verena UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Benzing, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Faetkenheuer, Gerd UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-433626
DOI:	10.1097/QAD.0000000000000324
Journal or Publication Title:	Aids
Volume:	28
Number:	12
Page Range:	S. 1783 - 1790
Date:	2014
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1473-5571
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GLOMERULAR-FILTRATION-RATE; CHRONIC KIDNEY-DISEASE; CORONARY-HEART-DISEASE; STAGE RENAL-DISEASE; CARDIOVASCULAR-DISEASE; INFECTED PATIENTS; ALL-CAUSE; AIDS MORTALITY; ALBUMINURIA; RISK Multiple languages Immunology; Infectious Diseases; Virology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43362