Long-Term kidney function, proteinuria, and associated risks among HIV-infected and uninfected men

Frank J. Palella, Xiuhong Li, Samir Gupta, Michelle M. Estrella, John P. Phair, Joseph B. Margolick, Roger Detels, Lawrence Kingsley, Lisa P. Jacobson

Research output: Contribution to journalArticle

Abstract

Background: Factors affecting kidney function and proteinuria among HIV-positive (HIV+) and HIV-negative (HIV-) persons need better characterization. Methods: We evaluated estimated glomerular filtration rate (EGFR, ml/min per 1.73 m 2) changes, proteinuria prevalence (a urine protein-To-creatinine ratio of ≥0.2 at two consecutive visits) and associated factors among HIV+ and HIV-men. Results: There were 917 HIV+ men receiving HAART, 159 HIV+ men not receiving HAART, and 1305 HIV-men seen from October 2003 to September 2014. Median annual EGFR change was-0.5,-0.8% for HIV+ and-0.3% for HIV-men (P < 0.001). Factors significantly (P < 0.05) associated with more than 3% annual EGFR decline were HAART receipt (but no specific antiretroviral drug), age more than 50, hypertension, diabetes, current smoking. Proteinuria existed in 14.9% of visit-pairs among HAART recipients, 5.8% among non-HAART recipients, and 1.9% among HIV-men, and was associated with subsequent annual more than 3% EGFR decline (odds ratio 1.80, P < 0.001). Proteinuria-Associated factors also included HAART use (vs. HIV-), age at least 50 (vs. <40), diabetes, hypertension, current smoking, hepatitis C virus-infection (all P < 0.05) and, among HIV+ men, lower CD4+ cell count, didanosine, saquinavir, or nelfinavir use (all P < 0.05). After adjusting for proteinuria, among HAART users, having a detectable HIV RNA, cumulative use of tenofovir disoproxil fumarate, emtricitabine, ritonavir, atazanavir, any protease inhibitor, or fluconazole were associated with more than 3% annual EGFR decline. Conclusion: Longitudinal kidney function decline was associated with HAART use but no individual antiretroviral drug, and traditional kidney disease risks. Proteinuria was nearly seven times more common in HAART-Treated men than HIV-men, reflected recent EGFR decline and predicted subsequent EGFR decline.

Original languageEnglish (US)
Pages (from-to)1247-1256
Number of pages10
JournalAIDS
Volume32
Issue number10
DOIs
StatePublished - Jun 19 2018

Fingerprint

Proteinuria
HIV
Kidney
Highly Active Antiretroviral Therapy
Tenofovir
Smoking
Nelfinavir
Saquinavir
Hypertension
Didanosine
Ritonavir
Fluconazole
Kidney Diseases
Virus Diseases
CD4 Lymphocyte Count
Protease Inhibitors
Glomerular Filtration Rate
Hepacivirus
Pharmaceutical Preparations
Creatinine

Keywords

  • HIV serostatus differences
  • longitudinal glomerular filtration rate
  • proteinuria
  • risks

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Palella, F. J., Li, X., Gupta, S., Estrella, M. M., Phair, J. P., Margolick, J. B., ... Jacobson, L. P. (2018). Long-Term kidney function, proteinuria, and associated risks among HIV-infected and uninfected men. AIDS, 32(10), 1247-1256. https://doi.org/10.1097/QAD.0000000000001807

Long-Term kidney function, proteinuria, and associated risks among HIV-infected and uninfected men. / Palella, Frank J.; Li, Xiuhong; Gupta, Samir; Estrella, Michelle M.; Phair, John P.; Margolick, Joseph B.; Detels, Roger; Kingsley, Lawrence; Jacobson, Lisa P.

In: AIDS, Vol. 32, No. 10, 19.06.2018, p. 1247-1256.

Research output: Contribution to journalArticle

Palella, FJ, Li, X, Gupta, S, Estrella, MM, Phair, JP, Margolick, JB, Detels, R, Kingsley, L & Jacobson, LP 2018, 'Long-Term kidney function, proteinuria, and associated risks among HIV-infected and uninfected men', AIDS, vol. 32, no. 10, pp. 1247-1256. https://doi.org/10.1097/QAD.0000000000001807
Palella, Frank J. ; Li, Xiuhong ; Gupta, Samir ; Estrella, Michelle M. ; Phair, John P. ; Margolick, Joseph B. ; Detels, Roger ; Kingsley, Lawrence ; Jacobson, Lisa P. / Long-Term kidney function, proteinuria, and associated risks among HIV-infected and uninfected men. In: AIDS. 2018 ; Vol. 32, No. 10. pp. 1247-1256.
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N2 - Background: Factors affecting kidney function and proteinuria among HIV-positive (HIV+) and HIV-negative (HIV-) persons need better characterization. Methods: We evaluated estimated glomerular filtration rate (EGFR, ml/min per 1.73 m 2) changes, proteinuria prevalence (a urine protein-To-creatinine ratio of ≥0.2 at two consecutive visits) and associated factors among HIV+ and HIV-men. Results: There were 917 HIV+ men receiving HAART, 159 HIV+ men not receiving HAART, and 1305 HIV-men seen from October 2003 to September 2014. Median annual EGFR change was-0.5,-0.8% for HIV+ and-0.3% for HIV-men (P < 0.001). Factors significantly (P < 0.05) associated with more than 3% annual EGFR decline were HAART receipt (but no specific antiretroviral drug), age more than 50, hypertension, diabetes, current smoking. Proteinuria existed in 14.9% of visit-pairs among HAART recipients, 5.8% among non-HAART recipients, and 1.9% among HIV-men, and was associated with subsequent annual more than 3% EGFR decline (odds ratio 1.80, P < 0.001). Proteinuria-Associated factors also included HAART use (vs. HIV-), age at least 50 (vs. <40), diabetes, hypertension, current smoking, hepatitis C virus-infection (all P < 0.05) and, among HIV+ men, lower CD4+ cell count, didanosine, saquinavir, or nelfinavir use (all P < 0.05). After adjusting for proteinuria, among HAART users, having a detectable HIV RNA, cumulative use of tenofovir disoproxil fumarate, emtricitabine, ritonavir, atazanavir, any protease inhibitor, or fluconazole were associated with more than 3% annual EGFR decline. Conclusion: Longitudinal kidney function decline was associated with HAART use but no individual antiretroviral drug, and traditional kidney disease risks. Proteinuria was nearly seven times more common in HAART-Treated men than HIV-men, reflected recent EGFR decline and predicted subsequent EGFR decline.

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