Urine Biomarkers of Kidney Tubule Health and Incident CKD Stage 3 in Women Living With HIV: A Repeated Measures Study.
Urine Biomarkers of Kidney Tubule Health and Incident CKD Stage 3 in Women Living With HIV: A Repeated Measures Study.
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DOI：
10.1016/j.xkme.2021.01.012
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发表时间：
2021-05
期刊：
影响因子：
3.9
通讯作者：
Shlipak MG
中科院分区：
文献类型：
--
作者：
Ascher SB;Scherzer R;Estrella MM;Jotwani VK;Shigenaga J;Spaulding KA;Ng DK;Gustafson D;Spence AB;Sharma A;Cohen MH;Parikh CR;Ix JH;Shlipak MG
Single measurements of urinary biomarkers reflecting kidney tubule health are associated with chronic kidney disease (CKD) risk in HIV infection, but the prognostic value of repeat measurements over time is unknown. Cohort study. 647 women living with HIV infection enrolled in the Women’s Interagency Health Study. 14 urinary biomarkers of kidney tubule health measured at 2 visits over a 3-year period. Incident CKD, defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 at two 6-month visits and an average eGFR decline ≥ 3% per year. We used multivariable generalized estimating equations adjusting for CKD risk factors to evaluate baseline, time-updated, and change-over-time biomarker associations with incident CKD. We compared CKD discrimination between models with and without a parsimoniously selected set of biomarkers. During a median 7 years of follow-up, 9.7% (63/647) developed CKD. In multivariable-adjusted analyses, 3 of 14 baseline biomarkers associated with incident CKD. In contrast, 10 of 14 time-updated biomarkers and 9 of 14 biomarkers modeled as change over time associated with incident CKD. Urinary epidermal growth factor (EGF), α1-microglobulin (A1M), and albumin were selected using penalized regression methods. In the time-updated model, lower urinary EGF (risk ratio [RR] per 2-fold higher time-updated biomarker levels, 0.69; 95% CI, 0.58-0.81), higher urinary A1M (RR, 1.47; 95% CI, 1.25-1.73), and higher urinary albumin excretion (RR, 1.21; 95% CI, 1.03-1.42) were jointly associated with increased risk for CKD. Compared with a base model (C statistic, 0.75), CKD discrimination improved after adding urinary EGF, A1M, and albumin values across baseline (C = 0.81), time-updated (C = 0.83), and change-over-time (C = 0.83) models (P < 0.01 for all). Observational design, incident CKD definition limited to eGFR. Repeat urinary biomarker measurements for kidney tubule health have stronger associations with incident CKD compared with baseline measurements and moderately improve CKD discrimination in women living with HIV infection.
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影响因子：
11.8
作者：
Guaraldi, Giovanni;Orlando, Gabriella;Palella, Frank
通讯作者：
Palella, Frank
影响因子：
1.2
作者：
Jotwani, Vasantha;Scherzer, Rebecca;Shlipak, Michael G.
通讯作者：
Shlipak, Michael G.
DOI：
10.1053/j.ajkd.2012.05.014
发表时间：
2012-12
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Peralta CA;Katz R;Bonventre JV;Sabbisetti V;Siscovick D;Sarnak M;Shlipak MG
通讯作者：
Shlipak MG
DOI：
10.2215/cjn.03220314
发表时间：
2015-01-01
影响因子：
9.8
作者：
Jotwani, Vasantha;Scherzer, Rebecca;Shlipak, Michael G.
通讯作者：
Shlipak, Michael G.
DOI：
10.2215/cjn.12051115
发表时间：
2016-08-01
影响因子：
9.8
作者：
Nadkarni, Girish N.;Rao, Veena;Coca, Steven G.
通讯作者：
Coca, Steven G.