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. 2022 Jul 4;22(1):591.
doi: 10.1186/s12879-022-07531-y.

Etiology of Persistent Microalbuminuria in Nigeria (P_MICRO study): protocol and study design

C William Wester  1   2 , Bryan E Shepherd  3 , Usman J Wudil  4 , Baba Maiyaki Musa  5   6 , Donna J Ingles  4 , Heather L Prigmore  3 , Faisal S Dankishiya  5 , Aima A Ahonkhai  4   7 , Bukar A Grema  8 , Philip J Budge  9 , Ayumi Takakura  10   11 , Opeyemi A Olabisi  12 , Cheryl A Winkler  13 , Jeffrey B Kopp  14 , Joseph V Bonventre  10   11 , Christina M Wyatt  12 , Muktar H Aliyu  4   15
Affiliations

Etiology of Persistent Microalbuminuria in Nigeria (P_MICRO study): protocol and study design

C William Wester et al. BMC Infect Dis. .

Abstract

Background: Microalbuminuria is an independent risk factor for cardiovascular and kidney disease and a predictor of end organ damage, both in the general population and in persons with HIV (PWH). Microalbuminuria is also an important risk factor for mortality in PWH treated with antiretroviral therapy (ART). In the ongoing Renal Risk Reduction (R3) study in Nigeria, we identified a high prevalence of microalbuminuria confirmed by two measurements 4-8 weeks apart in ART-experienced, virologically suppressed PWH. Although Stage 1 or 2 hypertension and exposure to potentially nephrotoxic antiretroviral medications were common in R3 participants, other traditional risk factors for albuminuria and kidney disease, including diabetes, APOL1 high-risk genotype, and smoking were rare. Co-infection with endemic pathogens may also be significant contributors to albuminuria, but co-infections were not evaluated in the R3 study population.

Methods: In Aim 1, we will cross-sectionally compare the prevalence of albuminuria and established kidney disease risk factors in a cohort of PWH to age- and sex-matched HIV-negative adults presenting for routine care at the Aminu Kano Teaching Hospital in Kano, Nigeria. We will leverage stored specimens from 2500 R3 participants and enroll an additional 500 PLWH recently initiated on ART (≤ 24 months) and 750 age- and sex-matched HIV-negative adults to determine the contribution of HIV, hypertension, and other comorbid medical conditions to prevalent albuminuria. In Aim 2, we will follow a cohort of 1000 HIV-positive, ART-treated and 500 HIV-negative normoalbuminuric adults for 30 months to evaluate the incidence and predictors of albuminuria.

Discussion: The findings from this study will support the development of interventions to prevent or address microalbuminuria in PWH to reduce kidney and cardiovascular morbidity and mortality. Such interventions might include more intensive monitoring and treatment of traditional risk factors, the provision of renin-angiotensin aldosterone system or sodium-glucose cotransporter-2 inhibitors, consideration of changes in ART regimen, and screening and treatment for relevant co-infections.

Keywords: APOL1; HIV; Kidney disease; Microalbuminuria; Nigeria.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Enrollment Chart
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References

    1. Matsushita K, van der Velde M, Astor BC, Woodward M, Levey AS, de Jong PE, Coresh J, Gansevoort RT, Chronic Kidney Disease Prognosis Consortium Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet. 2010;375(9731):2073–2081. doi: 10.1016/S0140-6736(10)60674-5. - DOI - PMC - PubMed
    1. Fox CS, Matsushita K, Woodward M, Bilo HJ, Chalmers J, Heerspink HJ, Lee BJ, Perkins RM, Rossing P, Sairenchi T, Tonelli M, Vassalotti JA, Yamagishi K, Coresh J, de Jong PE, Wen CP, Nelson RG, Chronic Kidney Disease Prognosis Consortium Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis. Lancet. 2012;380(9854):1662–1673. doi: 10.1016/S0140-6736(12)61350-6. - DOI - PMC - PubMed
    1. Khosla N, Sarafidis PA, Bakris GL. Microalbuminuria. Clin Lab Med. 2006;3:635–653. doi: 10.1016/j.cll.2006.06.005. - DOI - PubMed
    1. Mann JFE, Yi Q-L, Gerstein HC. Albuminuria as a predictor of cardiovascular and renal outcomes in people with known atherosclerotic cardiovascular disease. Kidney Int Suppl. 2004;66(Supplement 92):S59–S62. doi: 10.1111/j.1523-1755.2004.09215.x. - DOI - PubMed
    1. Gerstein HC, Mann JF, Yi Q, et al. Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals. JAMA, J Am Med Assoc. 2001;286(4):421–426. doi: 10.1001/jama.286.4.421. - DOI - PubMed

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