Proteinuria in Children Infected with the Human Immunodeficiency Virus

Chaparro, Aida; Mitchell, Charles D.; Abitbol, Carolyn; Wilkinson, James D.; Baldarrago, Giovanna; Lopez, E.; Zilleruelo, Gastón

doi:10.1016/j.jpeds.2007.11.007

Cited by 64 publications

(89 citation statements)

References 27 publications

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“…H IV-infected children can develop proteinuria secondary to several renal diseases, including immune complex glomerulopathies, thrombotic microangiopathies (TMA), and HIV-associated nephropathy (HIVAN) (1)(2)(3)(4)(5). In general, these renal diseases show a progressive clinical onset, and can have a significant clinical impact in the quality of life of HIV-infected children.…”

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confidence: 99%

“…Childhood HIVAN is typically seen in African American patients and is defined by the presence of heavy proteinuria, with mesangial hyperplasia or focal segmental glomerulosclerosis (FSGS) in association with microcystic tubular changes, leading to renal enlargement and rapid progression of the renal disease (1)(2)(3)(4)(5). HIV-infected children can also develop an atypical form of the Hemolytic Uremic Syndrome (HUS) characterized by a progressive clinical onset, lack of preceding diarrhea, preserved urine output with severe proteinuria, and rapid progression to end-stage renal disease or death due to infectious or bleeding complications (3,4,9).…”

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confidence: 99%

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Iron-Related Proteins

Soler-García¹,

Johnson²,

Hathout³

et al. 2009

Clinical Journal of the American Society of Nephrology

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Background: Because of the risk of performing renal biopsies in children with co-morbid conditions, we carried out this study to identify candidate protein biomarkers in the urine of HIV-infected children with renal disease.Design, setting, participants & measurements: Urine samples from HIV-infected children with biopsy proven HIVnephropathy (HIVAN; n ‫؍‬ 4), HIV-associated Hemolytic Uremic Syndrome (HIV-HUS; n ‫؍‬ 2), or no renal disease (n ‫؍‬ 3) were analyzed by two-dimensional electrophoresis (2-DE) and proteomic methods. Positive findings were confirmed in HIVinfected children with (n ‫؍‬ 20) and without (n ‫؍‬ 10) proteinuria using commercially available assays.Results: By 2-DE analysis, a single urine marker was not sufficient to distinguish children with HIVAN from the others. High urine levels of ␤ 2 -microglobulin and retinol-binding protein (RBP) suggested the presence of tubular injury. In addition, we found elevated urine levels of iron and the iron-related proteins, transferrin, hemopexin, haptoglobin, lactoferrin, and neutrophil gelatinase-associated lipocalin (NGAL), in children with HIVAN and HIV-HUS. Furthermore, we detected a significant accumulation of iron in the urine and kidneys of HIV-transgenic (Tg) rats with renal disease.Conclusion: These findings suggest that iron and iron-related proteins might be promising candidate urine biomarkers to identify HIV-infected children at risk of developing HIVAN and HIV-HUS. Moreover, based on the results of previous studies, we speculate that the release or accumulation of iron in the kidney of HIV-infected children may contribute to the rapid progression of their renal disease, and could become a new therapeutic target against HIVAN and HIV-HUS.

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confidence: 99%

mentioning

confidence: 99%

Iron-Related Proteins

Soler-García¹,

Johnson²,

Hathout³

et al. 2009

Clinical Journal of the American Society of Nephrology

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“…In another earlier cohort study in Miami, the frequency of proteinuria was 33% among 286 HIV-infected children and 11.2% had nephrotic range proteinuria; the mortality rate was higher among patients with proteinuria. 4 In contrast, the rate of proteinuria was lower in a more recent cohort study of HIVinfected youth in the United States. Drug-associated nephropathy is also common among HIVinfected children using antiretrovirals, such as tenofovir disoproxil fumarate (TDF) and indinavir.…”

Section: Introductionmentioning

confidence: 89%

“…However, the impact of these drugs on HIV-related nephropathy is uncertain, since most studies are underpowered to investigate drugrelated adverse events. 3,4 In a study of 448 children, more than 3 years of TDF use was independently associated with proteinuria. 5 Yet, TDF is being widely used, and is considered one of the first line nucleoside reverse transcriptase inhibitors (NRTIs) for use in children globally.…”

Section: Introductionmentioning

confidence: 99%

Short Communication: Kidney Dysfunction Among HIV-Infected Children in Latin America and the Caribbean

Hofer

Harris²,

Oliveira³

et al. 2014

AIDS Research and Human Retroviruses

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“…Sampling may be inadequate, the site of pathology may not be represented and the procedure, being invasive, is not without attendant complications. [4] To date, non-invasive strategies for detecting and monitoring the effect of kidney diseases in children primarily depend on: (i) abnormal urine sediments, including the presence of renal tubular epithelial and cast cells; [5] (ii) random urinary protein to creatinine ratio >1.0 mg/mg; [6] (iii) tubular disorders resulting in abnormalities in fluid and electrolyte balance; (iv) reduced glomerular filtration rate (GFR) <60 mL/min/1.73 m 2 ; and (v) an elevated serum creatinine level based on cut-offs that vary with age. Several factors are posed against the utility of serum creatinine levels as these values are influenced by body weight, nutritional status, protein intake and muscle mass, all of which are affected in HIV-infected children.…”

Section: Researchmentioning

confidence: 99%