Tubular and glomerular proteinuria in HIV-infected adults with estimated glomerular filtration rate ≥60 ml/min per 1.73 m2

Reynes, Jacques; Cournil, Amandine; Peyrière, Hélène; Psomas, Christina; Guiller, E.; Chatron, Marlène; Cristol, Jean‐Paul; Badiou, Stéphanie

doi:10.1097/qad.0b013e32835fac51

Cited by 27 publications

(33 citation statements)

References 37 publications

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“…We observed that the prevalence of glomerular and tubular proteinuria in our sample was close, 7.9 and 10.8%, respectively. This frequency of glomerular proteinuria is in accordance with other published data [4,5,12,31,32]. Studies that have attempted to evaluate glomerular and tubular proteinuria simultaneously during HIV infection are however scarce in the literature.…”

Section: Discussionsupporting

confidence: 91%

“…Studies that have attempted to evaluate glomerular and tubular proteinuria simultaneously during HIV infection are however scarce in the literature. Interestingly, Reynes et al [5] found similar results with an estimated frequency of proteinuria of 18.2% among patients with eGFR ≥60 mL/min/1.73 m 2 and among them, 50.7% had an albumin to protein ratio <0.4, and this was an indication of the presence of tubular proteinuria. In light of the relationship between the type of proteinuria and glomerular filtration, we found in our study that patients with a glomerular or tubular proteinuria had lower eGFRs at the beginning of each period compared to patients without proteinuria.…”

Section: Discussionmentioning

confidence: 68%

“…In this context, non-AIDS-related complications such as kidney disease have become increasingly important: chronic kidney disease (CKD) and low-grade proteinuria are indeed particularly frequent in HIV-infected patients in care [2,3,4,5,6]. CKD risk appears due to a combination of traditional and HIV-related risk factors.…”

Section: Introductionmentioning

confidence: 99%

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Absence of Decline of Kidney Function in Human Immunodeficiency Virus-Infected Patients Under Routine Clinical Management

Boucquemont

Lawson-Ayayi²,

Rigothier³

et al. 2017

Nephron

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Background: Since the introduction of antiretroviral therapy (ART), human immunodeficiency virus (HIV)-infected patients have a drastically improved prognosis but at the same time they are also more affected by non-HIV related complications, such as chronic kidney disease. The objective of our study was to investigate the effect of proteinuria and tenofovir (TDF)-containing ART regimens on the temporal evolution of estimated glomerular filtration rate (eGFR). Methods: Between April 2008 and October 2012, we enrolled 395 patients with a complete renal evaluation among patients from the ANRS C03 Aquitaine cohort, a prospective hospital-based cohort of HIV-1-infected patients under routine clinical management in southwestern France. eGFR was estimated at each patient follow-up visit. A linear mixed model was used to analyze eGFR dynamics, accounting for change in TDF by modeling eGFR trajectory according to treatment periods. Results: At inclusion, 56.7% of patients were treated with TDF-containing ART regimens; prevalence of glomerular and tubular proteinuria was 7.9 and 10.8% respectively. A 1-year increase of cumulative exposure to TDF was significantly associated with a mean eGFR decrease of 1.27 mL/min/1.73 m² (95% CI [-2.14 to -0.41]). Only a urine protein to creatinine ratio >100 mg/mmol and/or a urine albumin to creatinine ratio >70 mg/mmol were associated with eGFR trajectory (mean slope 6.18 mL/min/1.73 m² per year; 95% CI [2.71 to 9.65]), whereas TDF use was not associated with such eGFR temporal evolution. Conclusion: Decline in kidney function is limited under routine clinical management with monitoring of renal function and interventions including decision to continue or discontinue TDF.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 68%

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Absence of Decline of Kidney Function in Human Immunodeficiency Virus-Infected Patients Under Routine Clinical Management

Boucquemont

Lawson-Ayayi²,

Rigothier³

et al. 2017

Nephron

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“…Reynes et al [21] cross-sectionally evaluated the frequency of proteinuria, uAPR, and kidney tubular dysfunction in HIV-infected patients with normal estimated glomerular filtration rate and found TDF use was associated with increased tubular proteinuria and low uAPR. Samarawickrama et al [12] evaluated uAPR in HIV-infected patients and found that 12% of those receiving TDF therapy had tubular proteinuria, defined as uPCR more than 30 mg/mmol (265 mg/g creatinine) with uAPR less than 0.4.…”

Section: Discussionmentioning

confidence: 99%

“…Low-grade proteinuria is common in patients on antiretroviral therapy, and determining acceptable cutoffs in this population is an area requiring further study [21,23]. Additionally, it is necessary to determine the test characteristics of the uAPR in all HIV-infected patients who have proteinuria and undergo kidney biopsy.…”

Section: Discussionmentioning

confidence: 99%

Nonalbumin proteinuria predominates in biopsy-proven tenofovir nephrotoxicity

Sise

Hirsch

Canetta³

et al. 2015

Aids

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Hepatitis C virus increases the risk of kidney disease among HIV‐positive patients: Systematic review and meta‐analysis

Fabrizi

Dixit

Martin

2015

Journal of Medical Virology

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Kidney disease has become an important co-morbidity among human immunodeficiency virus-infected patients as they live longer in the era of highly effective antiretroviral therapy. It remains unclear how co-infection with hepatitis C virus impacts on the trajectory of kidney disease among HIV-infected patients. To evaluate the effect of co-infection with HCV on the risk of kidney disease in HIV-infected populations. We conducted a systematic review of the published medical literature to determine if hepatitis C co-infection is associated with increased likelihood of chronic kidney disease in HIV-positive adults. We used the random effects model of DerSimonian and Laird to generate a summary estimate of the relative risk for chronic kidney disease (defined by reduced glomerular filtration rate and/or detectable proteinuria) with hepatitis C virus across the published studies. Meta-regression and stratified analysis were also conducted. We identified 19 studies (146,151 unique patients with HIV) and separate meta-analyses were performed according to the outcome. Aggregation of longitudinal studies (n = 8, 105,462 unique patients) showed a relationship between HCV infection and increased risk of reduced glomerular filtration rate among HIV-infected individuals, the summary estimate for adjusted hazard ratio was 1.64 (95%CI, 1.28; 2.0, P < 0.001) in HIV-HCV co-infected individuals compared with those having HIV mono-infection. No between-studies heterogeneity was noted (P-value by Q test = 0.08). HCV positive serology was an independent risk factor for proteinuria; adjusted effect estimate, 1.23 (95% confidence interval, 1.18; 1.28, P = 0.001) (n = 6 studies; 26,835 unique patients). In meta-regression, we noted the impact of ageing (P = 0.0001) upon the adjusted hazard ratio of incidence of reduced glomerular filtration rate among HCV-HIV co-infected patients; a negative association between frequency of males (P = 0.001) and the adjusted hazard ratio of prevalence of low glomerular filtration rate was found. Hepatitis C co-infection is associated with a significant increase in the risk of reduced glomerular filtration rate and/or detectable proteinuria among HIV-infected individuals.

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Tubular and glomerular proteinuria in HIV-infected adults with estimated glomerular filtration rate ≥60 ml/min per 1.73 m2

Cited by 27 publications

References 37 publications

Absence of Decline of Kidney Function in Human Immunodeficiency Virus-Infected Patients Under Routine Clinical Management

Absence of Decline of Kidney Function in Human Immunodeficiency Virus-Infected Patients Under Routine Clinical Management

Nonalbumin proteinuria predominates in biopsy-proven tenofovir nephrotoxicity

Hepatitis C virus increases the risk of kidney disease among HIV‐positive patients: Systematic review and meta‐analysis

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