MO410: Early Endothelial Glycocalyx Injury Damage Associated With Further Kidney Dysfunction in Hiv Patients: Five Years Follow-Up

Abstract

BACKGROUND AND AIMS HIV patients have an increased risk of chronic kidney disease (CKD) development. Endothelial dysfunction was previously associated with kidney dysfunction markers. This study aims to investigate the association between renal markers and renal dysfunction biomarkers among outpatient HIV patients. METHOD Cohort study carried out with HIV patients in chronic use of Antiretroviral therapy followed up at a public outpatient service located in northeastern Brazil. Clinical and laboratory parameters of HIV patients were evaluated annually between 5 years: 2015 and 2019. Kidney dysfunction markers were blood creatinine and estimated glomerular filtration rate (GFR). Urinary kidney biomarkers NGAL, MCP-1, KIM-1 and serum endothelial biomarkers Syndecan-1 (glycocalyx), ICAM-1 and E-selectin were quantified in first-year using ELISA assays. RESULTS In total 66 patients completed the follow-up. Most patients were male (77.3%), of mixed race/color (57.6%), aged 39.33 ± 9.04 years. No patient had CKD development. However, Syndecan-1 showed a significant correlation with maximum creatinine (P < 0.001) and minimum GFR (P 0.003) over the years. Moreover, both creatinine and GFR in the last year had a significant association with syndecan-1 levels quantified 4 years ago. Multivariate linear regression with confounders showed a significant and independent association of syndecan-1 levels, current age and CD4 + count with minimum GFR. CONCLUSION HIV patients in chronic use of Antiretroviral therapy and glycocalyx injury may have an increased risk for long-term impacts on renal tissue. These data reinforce that endothelial impacts evaluation using biomarkers is a way to optimize the diagnosis and prognosis of kidney diseases, promoting the prevention of complications.