Persons with HIV infection are at substantially higher risk for kidney disease, compared with non-infected persons, and this is particularly a problem in African Americans. These risks may be related to the virus, to treatment, or to other factors. In addition, the diagnosis of kidney disease is substantially delayed or missed in persons with HIV with the current testing strategies. Our work has shown that a blood test, cystatin C, and specific urine proteins can achieve early detection of kidney disease and may be able to distinguish whether it is caused by med adverse effects, metabolic risk factors, or the HIV virus itself.

OUR PROJECTS

The Aging Kidney in HIV-Infection: biomarkers for early detection of injury

Principal Investigator: Michael G. Shlipak

Funding Source: National Institute of Aging (R01AG034853)

Project Summary: This grant adds novel biomarkers of injury to the microvasculature, tubules, and interstitium of the kidney and of bone mineral metabolism to the ongoing Multicenter AIDS Cohort Study (MACS) and the Women’s Interagency HIV Study (WIHS). The objectives of this project include: to compare kidney injury markers among HIV-infected and uninfected participants cross-sectionally, and their association with age, tenofovir use, and GFR; to examine the link between HIV-infection, advancing age, declining GFR, and tenofovir use with the disorders of mineral metabolism and reduced bone mineral density; and to evaluate longitudinally whether baseline and follow-up markers of kidney injury are independently associated with accelerated declines in kidney function.

Biomarkers of Drug-induced Kidney Injury in HIV

Principal Investigator: Vasantha Jotwani

Funding Source: National Institute of Diabetes and Digestive and Kidney Diseases (1K23 DK109868-01A1)

Project Summary: Tenofovir disoproxil fumarate (TDF), a widely prescribed antiretroviral medication for HIV treatment and pre-exposure prophylaxis (PrEP), has been associated with the development of acute kidney injury and chronic kidney disease. However, current clinical measures lack sensitivity and specificity for the detection of TDF-associated nephrotoxicity. Dr. Jotwani proposes to utilize novel urine biomarkers of tubular and mitochondrial damage to identify and monitor kidney injury in HIV-infected and uninfected persons who are receiving TDF.