全球心血管疾病一级预防人群中的蛋白尿和白蛋白尿:发病率和相关因素。

IF 3.4 2区 医学 Q3 IMMUNOLOGY
AIDS Pub Date : 2025-01-01 Epub Date: 2024-09-13 DOI:10.1097/QAD.0000000000004016
Edgar T Overton, Amy Kantor, Kathleen V Fitch, Mosepele Mosepele, Judith A Aberg, Carl J Fichtenbaum, Grace A McComsey, Carlos Malvestutto, Michael T Lu, Eugenia Negredo, Jose Bernardino, Aubri B Hickman, Pamela S Douglas, Steven K Grinspoon, Markella Zanni, Heather Ribaudo, Christina Wyatt
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引用次数: 0

摘要

目的确定 REPRIEVE 参与者中蛋白尿和白蛋白尿的基线患病率,并评估相关风险因素:对 REPRIEVE 试验参与者的基线样本进行横断面分析:REPRIEVE是一项国际性的心血管一级预防RCT试验,在接受抗逆转录病毒治疗的PWH人群中进行匹伐他汀钙与安慰剂的对比试验。有代表性的子集(2791 名参与者)在研究开始时收集了尿液。尿蛋白与肌酐比值(uPCR)和白蛋白与肌酐比值(uACR)分为正常、中度增高和严重增高。在进行对数二叉回归分析时,这些指标被二分为正常或异常。对结果正常与异常者的人口统计学、心脏代谢和艾滋病特异性数据进行了比较:总体而言,中位年龄为 49 岁,41% 为女性,47% 为黑人或非裔美国人,36% 有 eGFR:尽管艾滋病毒已得到控制,但蛋白尿和白蛋白尿异常仍很常见(分别为 27% 和 9%)。目前较低的 CD4 细胞数和 TDF 的使用与蛋白尿密切相关。某些可改变的合并症(包括高血压和吸烟)与异常值有关。在 eGFR 保持不变的感染者中,尿液测量可识别亚临床肾病,并提供干预机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Proteinuria and albuminuria among a global primary cardiovascular disease prevention cohort of people with HIV.

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.

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来源期刊
AIDS
AIDS 医学-病毒学
CiteScore
5.90
自引率
5.30%
发文量
478
审稿时长
3 months
期刊介绍: ​​​​​​​​​​​​​​​​​Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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