Ekrikpo UE, Okuku CN, Ajayi SO, Ayodele OE, Bello AK, Wonkam A, Dandara C, Kengne AP, Okpechi I. Urinary Transforming Growth Factor-Beta 1 (uTGF-β1) and Prevalent CKD Risk in HIV-Positive Patients in West Africa.
Kidney Int Rep 2019;
4:1698-1704. [PMID:
31844806 PMCID:
PMC6895576 DOI:
10.1016/j.ekir.2019.07.011]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 06/18/2019] [Accepted: 07/22/2019] [Indexed: 11/19/2022] Open
Abstract
Introduction
This study investigated the association of urinary transforming growth factor-β1 (uTGF-β1) with prevalent chronic kidney disease (CKD) in the HIV-infected population.
Methods
HIV-positive patients without CKD (HIV+CKD-, n = 194) and 114 with CKD (HIV+CKD+) who did not have hypertension, diabetes mellitus, or hepatitis B or C, had their urinary protein-creatinine ratio (uPCR), serum transforming growth factor (TGF)-β1, and uTGF-β1 measured. uTGF-β1-creatinine ratios (uTGF-β1Cr) were calculated. Spearman correlation was used to determine the association between uTGF-β1Cr and various attributes, and the Cuzick trend test was used to assess the presence of a linear trend in median uTGF-β1Cr levels across the stages of CKD. Multivariable robust linear regression models were used to assess independent association with variability in uTGF-β1Cr and estimated glomerular filtration rate (eGFR) levels.
Results
The age of the participants was 38.3 ± 10.3 years with 73.4% women. The median uTGF-β1Cr was higher among HIV+CKD+ (4.85 ng/mmol [25th-75th percentile 1.96-12.35] vs. 2.95 [1.02-5.84]; P = 0.001]). There was significant correlation between uTGF-β1Cr and age (P = 0.02), eGFR (P = 0.001), and uPCR (P < 0.001) in the HIV+CKD+ group. Among the HIV+CKD+ patients, there was gradual reduction in the median level of uTGF-β1Cr with CKD severity (P = 0.04). HIV+CKD+ patients had significantly higher levels of uTGF-β1Cr after controlling for potential confounders. Using eGFR as dependent variable, proteinuria explained the changes associated with uTGF-β1Cr levels.
Conclusion
HIV+CKD+ patients express higher levels of uTGF-β1 especially in the early stages of CKD apparently related to proteinuria levels.
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