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

• Published in: Journal of the International AIDS Society 2014-11, Vol.17 (4 Suppl 3), p.19561-n/a
• Main Authors: Mocroft, Amanda, Ryom, Lene, Lapadula, Giuseppe, Reiss, Peter, Blaxhult, Anders, Furrer, Hansjakob, Kutsyna, Galyna, Gatell, Jose, Begovac, Josep, Kirk, Ole, Lundgren, Jens
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; AIDS; Cardiovascular diseases; Complications and side effects; Data collection; Demographic aspects; Diagnosis; HIV; HIV infection; HIV infections; HIV-positive persons; Human immunodeficiency virus; Infeccions per VIH; Kidney diseases; Malalties del ronyó; Medicin och hälsovetenskap; Persones seropositives; Proteinuria; Proteïnúria; Renal function; Risk factors; Sexually transmitted diseases; STD; Urine
• ISSN: 1758-2652; 1758-2652
• DOI: 10.7448/IAS.17.4.19561

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 m2. 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 90) and those with prior abacavir use had lower odds of PTU (Figure 1). There was no significant association between past or current use of tenofovir, lopinavir, atazanvir (boosted or unboosted) or any other boosted PI and PTU (p>0.2). During 688.2 person‐years of follow up (PYFU), three persons developed chronic kidney disease (CKD; confirmed [>3 months apart] eGFR60 was almost 10 times higher than in those without baseline PTU and eGFR>60 (rate ratio 9.61; 95% CI 0.87–105.9, p=0.065). 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 a