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Incident Proteinuria by HIV Serostatus Among Men With Pre--Diabetes Mellitus: The Multicenter AIDS Cohort Study.
Slama, Laurence; Barrett, Benjamin W; Abraham, Alison G; Palella, Frank J; Magnani, Jared W; Viard, Jean Paul; Lake, Jordan E; Brown, Todd T.
Afiliación
  • Slama L; Infectious Diseases Unit, APHP, Hotel-Dieu Hospital, Paris, France.
  • Barrett BW; University Paris Cité and University Sorbonne Paris Nord, INSERM, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France.
  • Abraham AG; Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
  • Palella FJ; Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University, Baltimore, Maryland, USA.
  • Magnani JW; Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA.
  • Viard JP; Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
  • Lake JE; School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
  • Brown TT; Infectious Diseases Unit, APHP, Hotel-Dieu Hospital, Paris, France.
Clin Infect Dis ; 79(2): 469-476, 2024 Aug 16.
Article en En | MEDLINE | ID: mdl-38335094
ABSTRACT

BACKGROUND:

Pre-diabetes mellitus (DM) is associated with proteinuria, a risk factor for chronic kidney disease. While people with human immunodeficiency virus (HIV; PWH) have a higher risk of proteinuria than people without HIV (PWOH), it is unknown whether incident proteinuria differs by HIV serostatus among prediabetic persons.

METHODS:

The urine protein-to-creatinine ratio was measured at semiannual visits among men in the Multicenter AIDS Cohort Study since April 2006. Men with pre-DM on or after April 2006 and no prevalent proteinuria or use of antidiabetic medications were included. Pre-DM was defined as a fasting glucose level of 100-125 mg/dL confirmed within a year by a repeated fasting glucose or hemoglobin A1c measurement of 5.7%-6.4%. Incident proteinuria was defined as a urine protein-to-creatinine ratio (UPCR) >200 mg/g, confirmed within a year. We used Poisson regression models to determine whether incident proteinuria in participants with pre-DM differed by HIV serostatus and, among PWH, whether HIV-specific factors were related to incident proteinuria.

RESULTS:

Between 2006 and 2019, among 1276 men with pre-DM, proteinuria developed in 128 of 613 PWH (21%) and 50 of 663 PWOH (8%) over a median 10-year follow-up. After multivariable adjustment, the incidence of proteinuria in PWH with pre-DM was 3.3 times (95% confidence interval, 2.3-4.8 times) greater than in PWOH (P < .01). Among PWH, current CD4 cell count <50/µL (P < .01) and current use of protease inhibitors (P = .03) were associated with incident proteinuria, while lamivudine and integrase inhibitor use were associated with a lower risk.

CONCLUSIONS:

Among men with pre-DM, the risk of incident proteinuria was 3 times higher in PWH. Strategies to preserve renal function are needed in this population.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estado Prediabético / Proteinuria / Infecciones por VIH Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans / Male / Middle aged Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2024 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos
Texto completo
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Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estado Prediabético / Proteinuria / Infecciones por VIH Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans / Male / Middle aged Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2024 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos