Urine Biomarkers of Kidney Tubule Health and Incident CKD Stage 3 in Women Living With HIV: A Repeated Measures Study.
| Autor: | Ascher SB; Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Health Care System and University of California, San Francisco, San Francisco, CA.; Department of Medicine, University of California, Davis, Sacramento, CA., Scherzer R; Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Health Care System and University of California, San Francisco, San Francisco, CA., Estrella MM; Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Health Care System and University of California, San Francisco, San Francisco, CA., Jotwani VK; Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Health Care System and University of California, San Francisco, San Francisco, CA., Shigenaga J; Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Health Care System and University of California, San Francisco, San Francisco, CA., Spaulding KA; Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Health Care System and University of California, San Francisco, San Francisco, CA., Ng DK; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD., Gustafson D; Department of Neurology, The State University of New York Downstate Health Sciences University, Brooklyn, NY., Spence AB; Division of Infectious Diseases, Department of Medicine, Georgetown University Medical Center, Washington, DC., Sharma A; Department of Medicine, Albert Einstein College of Medicine, Bronx, NY., Cohen MH; Department of Medicine, Stroger Hospital and Rush University, Chicago, IL., Parikh CR; Division of Nephrology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD., Ix JH; Division of Nephrology-Hypertension, University of California, San Diego, San Diego, CA., Shlipak MG; Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Health Care System and University of California, San Francisco, San Francisco, CA. |
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| Jazyk: | angličtina |
| Zdroj: | Kidney medicine [Kidney Med] 2021 Apr 17; Vol. 3 (3), pp. 395-404.e1. Date of Electronic Publication: 2021 Apr 17 (Print Publication: 2021). |
| DOI: | 10.1016/j.xkme.2021.01.012 |
| Abstrakt: | Rationale & Objective: Single measurements of urinary biomarkers reflecting kidney tubule health are associated with chronic kidney disease (CKD) risk in HIV infection, but the prognostic value of repeat measurements over time is unknown. Study Design: Cohort study. Setting & Participants: 647 women living with HIV infection enrolled in the Women's Interagency Health Study. Exposures: 14 urinary biomarkers of kidney tubule health measured at 2 visits over a 3-year period. Outcome: Incident CKD, defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m 2 at two 6-month visits and an average eGFR decline ≥ 3% per year. Analytical Approach: We used multivariable generalized estimating equations adjusting for CKD risk factors to evaluate baseline, time-updated, and change-over-time biomarker associations with incident CKD. We compared CKD discrimination between models with and without a parsimoniously selected set of biomarkers. Results: During a median 7 years of follow-up, 9.7% (63/647) developed CKD. In multivariable-adjusted analyses, 3 of 14 baseline biomarkers associated with incident CKD. In contrast, 10 of 14 time-updated biomarkers and 9 of 14 biomarkers modeled as change over time associated with incident CKD. Urinary epidermal growth factor (EGF), α Limitations: Observational design, incident CKD definition limited to eGFR. Conclusions: Repeat urinary biomarker measurements for kidney tubule health have stronger associations with incident CKD compared with baseline measurements and moderately improve CKD discrimination in women living with HIV infection. (© 2021 The Authors.) |
| Databáze: | MEDLINE |
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