Urine kidney injury molecule-1 predicts subclinical kidney disease among persons living with HIV initiating tenofovir disoproxil fumarate-based ART in Zambia.

Journal: Frontiers in nephrology
Published Date: Jan 6, 2025

Abstract

INTRODUCTION: Antiretroviral therapy (ART) increases the life expectancy of persons living with HIV (PLWH), but not without potentially serious adverse effects. Tenofovir disoproxil fumarate (TDF) can cause nephrotoxicity, manifesting as acute kidney injury (AKI) that may persist after treatment discontinuation. Kidney injury biomarkers such as kidney injury molecule-1 (KIM-1), retinol-binding protein-4 (RBP-4), interleukin-18 (IL-18), and neutrophil gelatinase-associated lipocalin (NGAL) can aid early diagnosis and predict TDF-associated nephrotoxicity. This study aimed to determine whether the change from baseline in urine KIM-1 (δKIM-1) and NGAL (δNGAL) following 2 weeks of TDF use could predict subclinical TDF-associated nephrotoxicity before the overt manifestation as acute kidney disease after 3 months.

Authors

  • Freeman W Chabala
    The Institute of Basic and Biomedical Sciences, Levy Mwanawasa Medical University, Lusaka, Zambia.
  • Edward D Siew
    Department of Nephrology, Nephrology Vanderbilt O'Brien Center for Kidney Disease, Nashville, TN, United States.
  • C William Wester
    University of Alabama at Birmingham, Birmingham, AL, United States.
  • Alana T Brennan
    Department of Global Health, Boston University School of Public Health, Boston, MA, United States.
  • Masauso M Phiri
    Center for Primary Care Research, School of Medicine, University of Zambia, Lusaka, Zambia.
  • Michael J Vinikoor
    University of Alabama at Birmingham, Birmingham, AL, United States.
  • Sepiso K Masenga
    Department of Physiological Sciences, Mulungushi University School of Medicine and Health Sciences, Livingstone, Zambia.
  • Muktar H Aliyu
    Department of Nephrology, Nephrology Vanderbilt Institute for Global Health (VIGH), Nashville, TN, United States.

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