Microalbuminuria associated with indicators of inflammatory activity in an HIV-positive population

被引:40
作者
Baekken, Morten [1 ,2 ]
Os, Ingrid [2 ,3 ]
Sandvik, Leiv [4 ]
Oektedalen, Olav [1 ]
机构
[1] Ullevaal Univ Hosp, Dept Infect Dis, N-0407 Oslo, Norway
[2] Univ Oslo, Fac Med, Oslo, Norway
[3] Ullevaal Univ Hosp, Dept Nephrol, N-0407 Oslo, Norway
[4] Ullevaal Univ Hosp, Clin Res Ctr, N-0407 Oslo, Norway
关键词
beta; 2-microglobulin; blood pressure; combination antiretroviral treatment; HIV; microalbuminuria;
D O I
10.1093/ndt/gfn236
中图分类号
R3 [基础医学]; R4 [临床医学];
学科分类号
1001 ; 1002 ; 100602 ;
摘要
Background. The survival of human immunodeficiency virus (HIV)-infected patients has increased significantly since the introduction of combination antiretroviral therapy, leading to the development of important long-term complications including cardiovascular disease (CVD) and renal disease. Microalbuminuria, an indicator of glomerular injury, is associated with an increased risk of progressive renal deterioration, CVD and mortality. However, the prevalence of microalbuminuria has barely been investigated in HIV-infected individuals. Methods. Based on three prospective urine samples in an unselected nonhypertensive, nondiabetic HIV-positive cohort (n = 495), we analysed the prevalence of microalbuminuria and compared the Caucasian share with that of a nonhypertensive, nondiabetic population-based control group (n = 2091). Significant predictors for microalbuminuria were analysed within the HIV-positive cohort. Results. The prevalence of microalbuminuria was 8.7% in the HIV-infected cohort, which is three to five times higher than that in the general population. HIV-infected patients with microalbuminuria were older, and had higher blood pressure, longer duration of HIV infection, higher serum beta 2-microglobulin, higher serum creatinine and a reduced glomerular filtration rate of <= 90 mL/min, compared with those with normal albumin excretion. In multivariate analysis, systolic blood pressure, serum beta 2-microglobulin and duration of HIV infection were found to be independent predictors of microalbuminuria. Conclusions. Our findings indicate that in addition to haemodynamic effects, inflammatory activity may be implicated as a cause of the development of microalbuminuria. With respect to the increasing risk of developing CVD or renal diseases and mortality, the high prevalence of microalbuminuria in HIV-infected individuals warrants special attention.
引用
收藏
页码:3130 / 3137
页数:8
相关论文
共 44 条
[1]   AIDS-related vasculopathy: evidence for oxidative and inflammatory pathways in murine and human AIDS [J].
Baliga, RS ;
Chaves, AA ;
Jing, L ;
Ayers, LW ;
Bauer, JA .
AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY, 2005, 289 (04) :H1373-H1380
[2]   Cardiovascular and cerebrovascular events in patients treated for human immunodeficiency virus infection [J].
Bozzette, SA ;
Ake, CF ;
Tam, HK ;
Chang, SW ;
Louis, TA .
NEW ENGLAND JOURNAL OF MEDICINE, 2003, 348 (08) :702-710
[3]  
Bruggeman LA, 2000, J AM SOC NEPHROL, V11, P2079, DOI 10.1681/ASN.V11112079
[4]   MICROALBUMINURIA AS PREDICTOR OF INCREASED MORTALITY IN ELDERLY PEOPLE [J].
DAMSGAARD, EM ;
FROLAND, A ;
JORGENSEN, OD ;
MOGENSEN, CE .
BRITISH MEDICAL JOURNAL, 1990, 300 (6720) :297-300
[5]  
DARMINIO MA, 2005, ARCH INTERN MED, V0165
[6]   Inflammation and microalbuminuria in nondiabetic and type 2 diabetic subjects:: The Insulin Resistance Atherosclerosis Study [J].
Festa, A ;
D'Agostino, R ;
Howard, G ;
Mykkänen, L ;
Tracy, RP ;
Haffner, SM .
KIDNEY INTERNATIONAL, 2000, 58 (04) :1703-1710
[7]   Incidence and etiology of acute renal failure among ambulatory HIV-infected patients [J].
Franceschini, N ;
Napravnik, S ;
Eron, JJ ;
Szczech, LA ;
Finn, WF .
KIDNEY INTERNATIONAL, 2005, 67 (04) :1526-1531
[8]   Combination antiretroviral therapy and the risk of myocardial infarction [J].
Friis-Moller, N ;
Sabin, CA ;
Weber, R ;
Monforte, AD ;
El-Sadr, WM ;
Reiss, P ;
Thiébaut, R ;
Morfeldt, L ;
De Wit, S ;
Pradier, C ;
Calvo, G ;
Law, MG ;
Kirk, O ;
Phillips, AN ;
Lundgren, JD ;
Lundgren, JD ;
Weber, R ;
Monteforte, AD ;
Bartsch, G ;
Reiss, P ;
Dabis, F ;
Morfeldt, L ;
De Wit, S ;
Pradier, C ;
Calvo, G ;
Law, MG ;
Kirk, O ;
Phillips, AN ;
Houyez, F ;
Loeliger, E ;
Tressler, R ;
Weller, I ;
Friis-Moller, N ;
Sabin, CA ;
Sjol, A ;
Lundgren, JD ;
Sawitz, A ;
Rickenbach, M ;
Pezzotti, P ;
Krum, E ;
Meester, R ;
Lavignolle, V ;
Sundström, A ;
Poll, B ;
Fontas, E ;
Torres, F ;
Petoumenos, K ;
Kjær, J ;
Hammer, S ;
Neaton, J .
NEW ENGLAND JOURNAL OF MEDICINE, 2003, 349 (21) :1993-2003
[9]   Development of proteinuria or elevated serum creatinine and mortality in HIV-infected women [J].
Gardner, LI ;
Holmberg, SD ;
Williamson, JM ;
Szczech, LA ;
Carpenter, CCJ ;
Rompalo, AM ;
Schuman, P ;
Klein, RS .
JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, 2003, 32 (02) :203-209
[10]  
GOSLING P, 1995, BRIT J HOSP MED, V54, P285