A panel of urinary biochemical markers for the noninvasive detection of kidney dysfunction in HIV-infected patients

Abstract

Introduction: The use of antiretroviral therapy in HIV‑infected patients can lead to disturbances in kidney function. Renal dysfunction can also be caused by the direct effects of HIV on the kidneys. The assessment of renal function is needed to monitor these patients for the development of chronic kidney disease.

Objectives: The aim of this study was to identify urinary biochemical parameters for the assessment of kidney dysfunction in HIV‑infected patients.

Patients and methods: The study included 86 patients with HIV and 34 healthy controls. Spectrophotometry was used to measure the activity of the following enzymes: N‑acetyl-β‑D‑glucosaminidase (NAG), NAG isoenzyme B (NAG‑B), galactosidase, β‑glucuronidase, alanyl aminopeptidase, and γ‑glutamyltransferase. An enzyme‑linked immunosorbent assay was used to assess the urinary concentrations of low‑molecular‑weight proteins: kidney injury molecule 1 (KIM-1), neutrophil gelatinase-associated lipocalin, α‑glutathione S‑transferase, π‑glutathione S‑transferase, neopterin, β2‑microglobulin (β2M), and retinol‑binding protein (RBP).

Results: The urinary levels of all parameters except alanyl aminopeptidase were significantly higher in HIV‑infected patients than in the control group. The statistical analysis revealed the following 4 parameters to have the best diagnostic value in: β2M, NAG, KIM-1, and RBP.

Conclusions: Our results indicate that among selected enzymes and low-molecular proteins, β2M, NAG, KIM-1, and RBP are the best in assessing renal dysfunction in patients with HIV.