The prevalence and predictive value of dipstick urine protein in HIV-positive persons in Europe.

Mocroft, Amanda; Ryom, Lene; Lapadula, Giuseppe; Reiss, Peter; Blaxhult, Anders; Furrer, Hansjakob; Kutsyna, Galyna; Gatell, Jose; Begovac, Josep; Kirk, Ole; Lundgren, Jens (2014). The prevalence and predictive value of dipstick urine protein in HIV-positive persons in Europe. Journal of the International AIDS Society, 17(4,Suppl3), p. 19561. BioMed Central 10.7448/IAS.17.4.19561

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INTRODUCTION Proteinuria (PTU) is an important marker for the development and progression of renal disease, cardiovascular disease and death, but there is limited information about the prevalence and factors associated with confirmed PTU in predominantly white European HIV+ persons, especially in those with an estimated glomerular filtration rate (eGFR) of 60 mL/min/1.73 m(2). PATIENTS AND METHODS Baseline was defined as the first of two consecutive dipstick urine protein (DPU) measurements during prospective follow-up >1/6/2011 (when systematic data collection began). PTU was defined as two consecutive DUP >1+ (>30 mg/dL) >3 months apart; persons with eGFR <60 at either DPU measurement were excluded. Logistic regression investigated factors associated with PTU. RESULTS A total of 1,640 persons were included, participants were mainly white (n=1,517, 92.5%), male (n=1296, 79.0%) and men having sex with men (n=809; 49.3%). Median age at baseline was 45 (IQR 37-52 years), and CD4 was 570 (IQR 406-760/mm(3)). The median baseline date was 2/12 (IQR 11/11-6/12), and median eGFR was 99 (IQR 88-109 mL/min/1.73 m(2)). Sixty-nine persons had PTU (4.2%, 95% CI 3.2-4.7%). Persons with diabetes had increased odds of PTU, as were those with a prior non-AIDS (1) or AIDS event and those with prior exposure to indinavir. Among females, those with a normal eGFR (>90) and those with prior abacavir use had lower odds of PTU (Figure 1). CONCLUSIONS One in 25 persons with eGFR>60 had confirmed proteinuria at baseline. Factors associated with PTU were similar to those associated with CKD. The lack of association with antiretrovirals, particularly tenofovir, may be due to the cross-sectional design of this study, and additional follow-up is required to address progression to PTU in those without PTU at baseline. It may also suggest other markers are needed to capture the deteriorating renal function associated with antiretrovirals may be needed at higher eGFRs. Our findings suggest PTU is an early marker for impaired renal function.

Item Type:

Conference or Workshop Item (Abstract)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Furrer, Hansjakob

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1758-2652

Publisher:

BioMed Central

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

01 Dec 2014 16:32

Last Modified:

29 Dec 2015 17:07

Publisher DOI:

10.7448/IAS.17.4.19561

PubMed ID:

25394068

BORIS DOI:

10.7892/boris.60170

URI:

https://boris.unibe.ch/id/eprint/60170

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