Comparison of Levels of Nephropathy Biomarkers in HIV-infected Individuals and Healthy Volunteers

Abstract

Introduction: The number of human immunodeficiency virus (HIV)-infected individuals (HIIs) is increasing day by day and life expectancy is prolonged with the use of highly active antiretroviral therapy (HAART). With the advancing age, chronic diseases that may cause renal dysfunction will also begin to appear. In addition, HIV-associated nephropathy due to inflammation caused by HIV itself and renal dysfunction due to HAART use have been reported in the literature. Considering the social and medical problems caused by HIV, nephropathy as an additional disease makes patient management difficult. Therefore, it is important to detect nephropathy in the early period and take precautions. Creatinine is not always sufficient in the evaluation of nephropathy. New searches are needed in demonstrating nephropathy in HIIs compared to healthy individuals. It was aimed to evaluate cystatin C and NGAL levels in serum, and KIM1 and NGAL levels in urine to determine whether nephropathy developed in HIIs. Materials and Methods: Eighty-eight HIIs in whom renal dysfunction was not detected before and 81 healthy individuals were prospectively evaluated. Cystatin C and NGAL levels were studied in serum samples, while KIM1 and NGAL were studied in urine samples. Serum creatinine, spot urine protein and creatinine levels were recorded in these patients. Results: Of all participants, 114 (67.5%) were male and 55 (32.5%) were female. It was observed that the estimated-glomerular filtration rate (eGFR) was higher, cystatin C level in serum, and NGAL level in serum and urine were higher in the control group than the patient group. Serum creatinine, urinary protein and urinary creatinine levels were higher in the HIV-infected patient group compared to the healthy control group (p<0.05). The estimated-glomerular filtration rate was lower in patients using tenofovir disoproxil fumarate (TDF) than in patients not using TDF (p=0.017). When all participants were evaluated, urinary NGAL level was higher in women (p<0.001). Conclusion: In our study, HIIs had higher creatinine levels and lower eGFR compared to the control group. In the control group, cystatin C in serum and NGAL in urine and serum were higher. These parameters did not correlate with creatinine level and creatinine-based eGFR in serum, which were standardized to assess renal function. Our study was a cross-sectional study and only one measurement was made. In our study, the NGAL level was found to be higher in women, especially in the urine, and it was necessary to pay attention to the gender factor when using nephropathy markers. Low eGFR was noteworthy in patients using TDF.

Keywords

• hiv
• nephropathy
• cystatin c
• kim1
• ngal