Microalbuminuria in HIV Disease
| Autor: | Jeffrey B. Kopp, Antoinette Johnson, JoAnn M. Mican, Lilian Howard, Alexandra Adler, Julia B. Purdy, Colleen Hadigan, Margo A. Smith, Akinbowale Oyalowo, Catherine Rehm, Leon Lai, Estee Fleischman, Elizabeth J. Edwards, Karmini Sampath, Alice Rosenberg |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty endocrine system diseases Population HIV Infections urologic and male genital diseases Gastroenterology Article chemistry.chemical_compound Predictive Value of Tests Internal medicine Prevalence Albuminuria Humans Medicine Prospective Studies education Creatinine education.field_of_study Proteinuria business.industry Middle Aged medicine.disease United States female genital diseases and pregnancy complications Logistic Models Elevated serum creatinine Endocrinology chemistry Nephrology Predictive value of tests Female Microalbuminuria medicine.symptom business Kidney disease |
| Zdroj: | American Journal of Nephrology. 37:443-451 |
| ISSN: | 1421-9670 0250-8095 |
| DOI: | 10.1159/000350384 |
| Popis: | Background/Aims: Microalbuminuria is a marker for early kidney disease and cardiovascular risk. The purposes of this study were to determine the prevalence of microalbuminuria in an HIV-infected clinic population, to test the predictive value of a single urine albumin/creatinine ratio (ACR) to identify persistent microalbuminuria and to examine covariates of microalbuminuria. Methods: We conducted a prospective cohort study of HIV-infected subjects (n = 182) without proteinuria (urine protein/creatinine ratio ≥0.5 g/g), elevated serum creatinine, diabetes, or chronic inflammatory conditions. Subjects completed three research visits within 9 months. Microalbuminuria was defined as the geometric mean ACR of 25-355 mg/g for females and 17-250 mg/g for males. Results: The prevalence of microalbuminuria was 14%. The negative predictive value of a single urine ACR determination was 98%, whereas the positive predictive value was only 74%. Microalbuminuria was similar among Black (15%) and non-Black (14%) subjects (p = 0.8). Subjects with microalbuminuria were more likely to have hypertension (p = 0.02) and metabolic syndrome (p = 0.03). While duration of HIV infection and the level of HIV viremia were similar between groups, those with microalbuminuria were more likely to have a CD4 count Conclusion: The prevalence of microalbuminuria in an HIV-infected clinic population was similar to earlier reports, and was associated with hypertension and impaired immune function. A single normal ACR determination effectively excludes microalbuminuria, whereas an elevated ACR requires confirmation. |
| Databáze: | OpenAIRE |
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