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. 2008 Oct;23(10):3130-7.
doi: 10.1093/ndt/gfn236. Epub 2008 May 9.

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

Morten Baekken  1 , Ingrid Os, Leiv Sandvik, Olav Oektedalen
Affiliations

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

Morten Baekken et al. Nephrol Dial Transplant. 2008 Oct.

Abstract

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 < or =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.

Keywords: HIV; beta 2-microglobulin; blood pressure; combination antiretroviral treatment; microalbuminuria.

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Figures

Fig. 1
Fig. 1
Flow chart of the HIV-infected population in the study. Asterisk represents the estimated number of HIV-infected patients living in Oslo in 2004, based on the Norwegian Surveillance System for Communicable Diseases (MSIS).
Fig. 2
Fig. 2
(a) Distributions of the prevalence of microalbuminuria (MA) related to the quartile durations since HIV test in the total population (n = 495), men (n = 354) and women (n = 141). (b) Distributions of the prevalence of MA related to the quartile levels of serum beta 2-microglobulin in the total HIV-infected population (n = 493), men (n = 353) and women (n = 140).
See this image and copyright information in PMC

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