Microalbuminuria associated with indicators of inflammatory activity in an HIV-positive population.
Microalbuminuria associated with indicators of inflammatory activity in an HIV-positive population.
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DOI：
10.1093/ndt/gfn236
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发表时间：
2008-10
期刊：
影响因子：
--
通讯作者：
Oektedalen O
中科院分区：
文献类型：
--
作者：
Baekken M;Os I;Sandvik L;Oektedalen O
背景。自从引入联合抗逆转录病毒疗法以来，人类免疫缺陷病毒（HIV）感染患者的生存率显着增加，导致包括心血管疾病（CVD）和肾脏疾病在内的重要长期并发症的发生。微量白蛋白尿是肾小球损伤的一个指标，与进行性肾功能恶化、心血管疾病和死亡的风险增加有关。然而，几乎没有对 HIV 感染者中微量白蛋白尿的患病率进行过调查。方法。基于未经选择的非高血压、非糖尿病 HIV 阳性队列 (n = 495) 的三个前瞻性尿液样本，我们分析了微量白蛋白尿的患病率，并将白人比例与非高血压、非糖尿病人群对照组 (n = 2091) 进行了比较。在 HIV 阳性队列中分析了微量白蛋白尿的重要预测因素。结果。 HIV感染者中微量白蛋白尿的患病率为8.7%，是普通人群的三到五倍。与白蛋白排泄正常的患者相比，微量白蛋白尿的HIV感染者年龄较大，血压较高，HIV感染持续时间较长，血清β2微球蛋白较高，血清肌酐较高，肾小球滤过率降低至≤90mL/min。在多变量分析中，发现收缩压、血清 β2-微球蛋白和 HIV 感染持续时间是微量白蛋白尿的独立预测因子。结论。我们的研究结果表明，除了血流动力学影响之外，炎症活动可能是微量白蛋白尿发生的原因之一。鉴于罹患心血管疾病或肾脏疾病和死亡率的风险不断增加，艾滋病毒感染者中微量白蛋白尿的高患病率值得特别关注。
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.
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