Selected biochemical parameters in the urine of HIV-infected patients in monitoring of kidney function
 
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1
Department of Toxicology, Faculty of Pharmacy, Wroclaw Medical University, Wroclaw, Poland
2
Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiencies, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
CORRESPONDING AUTHOR
Beata Szymańska   

Wroclaw Medical University, Department of Toxicology
Submission date: 2019-06-26
Final revision date: 2019-11-12
Acceptance date: 2019-11-24
Online publication date: 2021-05-22
 
 
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ABSTRACT
Introduction:
For years, there has been an increase in the number of cases of chronic kidney disease (CKD) in human immunodeficiency virus (HIV)-infected patients. Renal dysfunction can be caused by direct effects of HIV on the kidneys but also of applied combined antiretroviral therapy (cART). Therefore there is a need of renal function diagnosis to monitor the development of kidney disturbances. In this study the urinary levels of selected low molecular weight proteins (LMWP) in HIV-infected patients were measured and related to current CD4+ T lymphocyte (LT CD4+) count, the glomerular filtration rate (eGFR) value and the applied cART.

Material and methods:
The levels of 5 LMWP – kidney injury molecule-1 (KIM-1), neutrophil gelatinase associated lipocalin (NGAL), glutathione S-transferase α (GST-α) and π (GST-π) isoenzymes and neopterin (NPT) – in urine were measured in HIV-infected patients and healthy controls by enzyme-linked immunosorbent assay.

Results:
Taking into account the current LT CD4+ count, KIM-1, NGAL and GST-α showed statistically significant differences between groups with the CD4+ count < 500 and ≥ 500 cells (< 0.001). Depending on the eGFR, apart from KIM-1 and NGAL, NPT showed statistically significant differences in the investigated groups with normal and lower eGFR values (< 0.001). In terms of applied cART, the best parameters in the assessment of kidney damage were NGAL, GST-π and NPT (< 0.001).

Conclusions:
This research shows that the analyzed LMWP parameters are useful in the assessment of kidney damage in HIV patients during cART, especially NPT, NGAL and GST-π. However, future studies should be conducted on larger groups.

eISSN:1896-9151
ISSN:1734-1922