TY - JOUR
T1 - Proteinuria and albuminuria among a global primary cardiovascular disease prevention cohort of people with HIV
AU - REPRIEVE Trial Investigators
AU - Overton, Edgar T.
AU - Kantor, Amy
AU - Fitch, Kathleen V.
AU - Mosepele, Mosepele
AU - Aberg, Judith A.
AU - Fichtenbaum, Carl J.
AU - McComsey, Grace A.
AU - Malvestutto, Carlos
AU - Lu, Michael T.
AU - Negredo, Eugenia
AU - Bernardino, Jose
AU - Hickman, Aubri B.
AU - Douglas, Pamela S.
AU - Grinspoon, Steven K.
AU - Zanni, Markella
AU - Ribaudo, Heather
AU - Wyatt, Christina
N1 - Publisher Copyright:
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2025/1/1
Y1 - 2025/1/1
N2 - OBJECTIVES: To determine baseline prevalence of proteinuria and albuminuria among participants from the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) and evaluate associated risk factors. DESIGN: Cross sectional analysis of a baseline sample of participants from the REPRIEVE Trial. METHODS: REPRIEVE is an international primary cardiovascular prevention randomized controlled trial (RCT) of pitavastatin calcium vs. placebo among people with HIV (PWH) on antiretroviral therapy (ART). A representative subset (2791 participants) had urine collected at study entry. Urine protein to creatinine ratios (uPCR) and albumin to creatinine ratios (uACR) were classified as normal, moderately increased and severely increased. These were dichotomized to Normal or Abnormal for log-binomial regression analysis. Demographic, cardiometabolic, and HIV-specific data were compared among those with normal versus abnormal results. RESULTS: Overall, median age 49 years, 41% female sex, 47% black or African American race, 36% had estimated glomerular filtration rate (eGFR) less than 90 ml/min/1.73 mm 2 . For uPCR, 27% had moderately or severely increased values. For uACR, 9% had moderately or severely increased values. In the fully adjusted model for proteinuria, female sex, older age, residence in sub-Saharan Africa or East Asia, lower BMI, lower CD4 + cell count, and use of tenofovir disoproxil fumarate (TDF) were associated with abnormal values. In the fully adjusted model for albuminuria, a diagnosis of hypertension (HTN) was associated with abnormal values. CONCLUSION: Abnormal proteinuria and albuminuria remain common (27 and 9%) despite controlled HIV. Lower current CD4 + count and TDF use were strongly associated with proteinuria. Certain modifiable comorbidities, including HTN and smoking, were associated with abnormal values. In PWH with preserved eGFR, urine measures identify subclinical kidney disease and afford the opportunity for intervention.
AB - OBJECTIVES: To determine baseline prevalence of proteinuria and albuminuria among participants from the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) and evaluate associated risk factors. DESIGN: Cross sectional analysis of a baseline sample of participants from the REPRIEVE Trial. METHODS: REPRIEVE is an international primary cardiovascular prevention randomized controlled trial (RCT) of pitavastatin calcium vs. placebo among people with HIV (PWH) on antiretroviral therapy (ART). A representative subset (2791 participants) had urine collected at study entry. Urine protein to creatinine ratios (uPCR) and albumin to creatinine ratios (uACR) were classified as normal, moderately increased and severely increased. These were dichotomized to Normal or Abnormal for log-binomial regression analysis. Demographic, cardiometabolic, and HIV-specific data were compared among those with normal versus abnormal results. RESULTS: Overall, median age 49 years, 41% female sex, 47% black or African American race, 36% had estimated glomerular filtration rate (eGFR) less than 90 ml/min/1.73 mm 2 . For uPCR, 27% had moderately or severely increased values. For uACR, 9% had moderately or severely increased values. In the fully adjusted model for proteinuria, female sex, older age, residence in sub-Saharan Africa or East Asia, lower BMI, lower CD4 + cell count, and use of tenofovir disoproxil fumarate (TDF) were associated with abnormal values. In the fully adjusted model for albuminuria, a diagnosis of hypertension (HTN) was associated with abnormal values. CONCLUSION: Abnormal proteinuria and albuminuria remain common (27 and 9%) despite controlled HIV. Lower current CD4 + count and TDF use were strongly associated with proteinuria. Certain modifiable comorbidities, including HTN and smoking, were associated with abnormal values. In PWH with preserved eGFR, urine measures identify subclinical kidney disease and afford the opportunity for intervention.
UR - http://www.scopus.com/inward/record.url?scp=85212002949&partnerID=8YFLogxK
U2 - 10.1097/QAD.0000000000004016
DO - 10.1097/QAD.0000000000004016
M3 - Article
C2 - 39283736
AN - SCOPUS:85212002949
SN - 0269-9370
VL - 39
SP - 31
EP - 39
JO - AIDS
JF - AIDS
IS - 1
ER -