Proteinuria is common among HIV patients: what are we missing?

Antonello, Vicente Sperb; Antonello, Ivan Carlos Ferreira; Herrmann, Joerg; Tovo, Cristiane Valle

doi:10.6061/clinics/2015(10)06

Cited by 10 publications

(9 citation statements)

References 19 publications

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“…All these studies used uPCR ≥ 0.2 to determine proteinuria. This high prevalence indicates that impaired renal function is indeed an important complication in HIV patients [20].…”

Section: Discussionmentioning

confidence: 99%

Correlation between CD4 count and glomerular filtration rate or urine protein:creatinine ratio in human immunodeficiency virus-infected children

Aliyannissa

Kuswiyanto

Setiabudi

et al. 2020

Kidney Res Clin Pract

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Kidney issues are an important complication of human immunodeficiency virus (HIV) infection, with prevalence varying between 5% to 48.5% worldwide [1-3]. Deaths due to kidney diseases account for 12.2% of all HIV patient deaths [4]. In Sub-Saharan Africa, a 67% increase in mortality due to nephritis and nephrosis has been reported from 1999 to 2006 [5]. Not only are patients with HIV infection at greater risk of kidney disease, but they are also more likely to experience faster kidney dysfunction progression compared to individuals without HIV

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“…All these studies used uPCR ≥ 0.2 to determine proteinuria. This high prevalence indicates that impaired renal function is indeed an important complication in HIV patients [20].…”

Section: Discussionmentioning

confidence: 99%

Correlation between CD4 count and glomerular filtration rate or urine protein:creatinine ratio in human immunodeficiency virus-infected children

Aliyannissa

Kuswiyanto

Setiabudi

et al. 2020

Kidney Res Clin Pract

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“…44 Additionally, pathological proteinuria, defined as uPCR of 150 mg/g, was also found to be 20% in HIV patients, but with no difference observed between the groups receiving highly active anti-retroviral therapy (HAART) and not receiving HAART. 45…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Nephrotoxicity in HIV Patients Treated with Tenofovir Disoproxil Fumarate: A Single-center Observational Study

Hassan

Balkhair

2019

OMJ

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Objectives Tenofovir disoproxil fumarate (TDF) has been reported to cause nephrotoxicity necessitating cessation in some patients. No information is available on the nephrotoxic effect of TDF in Omani or regional patients with HIV infection. We sought to determine the prevalence of the nephrotoxic effects of TDF in our cohort of Omani patients with HIV and investigate the nephrotoxic effects of other cofactors. Methods We conducted an observational cohort study on 83 Omani patients currently on TDF-containing antiretroviral therapy. Renal dysfunction was monitored by measuring the serum creatinine estimated glomerular function rate (eGFR), urinary protein creatinine ratio (uPCR), and fractional excretion of phosphate (FEPi). Fisher’s exact test was used to determine any additional nephrotoxic effects of cofactors. Results The median values for the duration of TDF use, patient age, and body mass index (BMI) at the time of the study were 178 weeks (range = 3–554), 42 years (range = 21–80), and 27 (range = 17.4–42.7), respectively. The median initial CD4 count and viral load were 205 × 10 6 /L (range = 3–1745) and 37 250 copies/mL (range = undetectable–9 523 428), respectively. FEPi was high in two (2.4%) patients, moderate in 26 (31.3%), and low in 55 (66.3%) patients. uPCR was high in 10 (12.0%) patients, moderate in 28 (33.7%), and low in 45 (54.2%) patients. No cofactors added to the nephrotoxicity except hypertension ( p = 0.045). Conclusions Better definitions for TDF-associated toxicity are needed. uPCR is not a very good indicator of TDF-associated tubular dysfunction. Omani patients with HIV on TDF have a 4% prevalence of renal toxicity, but a study with a larger number of patients is required to explore this observation further. Cofactors like duration of TDF use, age, BMI, gender, diabetes mellitus, and use of protease inhibitors did not have an impact on the severity of FEPi and uPCR.

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“…26 Assessment of proteinuria is important to stratify the risk of progression of CKD and cardiovascular risk. 27 The introduction of cART, by prolonging survival of HIV-infected patients, also increased the prevalence of cardiovascular disease. 25 Risk factors for cardiovascular disease are a combination of traditional risk factors, such as hypertension, diabetes and CKD, and the impact of HIV infection and antiretroviral therapy.…”

Section: Renal Function Assessment In Hiv-infected Patientsmentioning

confidence: 99%

“…25 Risk factors for cardiovascular disease are a combination of traditional risk factors, such as hypertension, diabetes and CKD, and the impact of HIV infection and antiretroviral therapy. 25,27 Cardiovascular risk should be assessed before beginning cART and frequently during follow-up. 25,27 Patients with HIV-associated renal disease have a strong indication to start cART, and if there is no improvement of renal function, angiotensinconverting enzyme inhibitors or angiotensin-receptor blockers and/or prednisone may be added.…”

Section: Renal Function Assessment In Hiv-infected Patientsmentioning

confidence: 99%

“…25,27 Cardiovascular risk should be assessed before beginning cART and frequently during follow-up. 25,27 Patients with HIV-associated renal disease have a strong indication to start cART, and if there is no improvement of renal function, angiotensinconverting enzyme inhibitors or angiotensin-receptor blockers and/or prednisone may be added. 4,11 In these patients standard therapies for CKD are recommended, such as blood pressure lower than 140/90 mmHg, glycaemic control, control of serum urate and bicarbonate, smoking cessation and removal of nephrotoxins.…”

Section: Renal Function Assessment In Hiv-infected Patientsmentioning

confidence: 99%

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HIV and renal disease: a contemporary review

2018

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The presence of human immunodeficiency virus (HIV)-related kidney disease is an important cause of mortality and morbidity. HIV infection induces renal injury by direct cytotoxicity or immune complex-mediated glomerulonephritis in patients with genetic susceptibility factors. In the last decades, with the development and diffusion of combination antiretroviral therapy, which has prolonged patient survival, there has been a shift in the spectrum of renal diseases in HIV-infected patients, with the decrease of glomerular diseases and increase in the role of nephrotoxicity and co-morbidities. This review provides a contemporary and critical review on the main renal syndromes occurring in HIV-infected patients.

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Proteinuria is common among HIV patients: what are we missing?

Cited by 10 publications

References 19 publications

Correlation between CD4 count and glomerular filtration rate or urine protein:creatinine ratio in human immunodeficiency virus-infected children

Correlation between CD4 count and glomerular filtration rate or urine protein:creatinine ratio in human immunodeficiency virus-infected children

Prevalence of Nephrotoxicity in HIV Patients Treated with Tenofovir Disoproxil Fumarate: A Single-center Observational Study

HIV and renal disease: a contemporary review

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