Urinary Biomarkers Useful for Assessing Acute Kidney Injury in Patients With HIV

Urine biomarkers of kidney tubular injury are strongly correlated with acute kidney injury (AKI) in patients with HIV, according to results published in AIDS. In the Preditors of Acute Renal Injury Study, Michelle Estrella, MD, and colleagues evaluated 10 urine biomarkers related to kidney health, including albumin, neutrophil gelatinase associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and monocyte chemoattractant protein-1 (MCP-1), among 468 people with HIV (mean age, 53; 45% women). In time-updated models adjusting for sociodemographic factors, comorbidities, albuminuria, estimated glomerular filtration rate, and HIV associated factors, higher KIM-1 (HR, 1.30 per 2-fold higher; 95% CI, 1.03-1.63) and NGAL concentrations (HR, 1.24; 95% CI, 1.06-1.44) were associated with increased risk for AKI hospitalization. In multivariable time-updated models, increased levels of KIM-1 (HR, 1.19; 95% CI, 1.00- 1.41), NGAL (HR, 1.13; 95% CI, 1.01-1.26), and MCP-1 (HR, 1.20; 95% CI, 1.00-1.45) were associated with an increased risk for hospitalization. The findings suggest that urinary biomarkers of kidney tubular injury may be potential markers “for risk stratification of future AKI,” according to Dr. Estrella and colleagues.