Muiru AN, Scherzer R, Ascher SB, et al. - Women living with HIV show unique patterns of biomarker changes in correlation with chronic kidney disease (CKD) risk factors, indicating the possible value of serial measurements of multiple biomarkers in detecting and monitoring kidney disease in this setting.

• From the Women’s Interagency Health Study (WIHS), 647 women living with HIV were assessed for traditional and infection-related CKD risk factors; 14 urine biomarkers were measured at baseline and at follow-up.

• Findings revealed association of each traditional and infection-related CKD risk factor with a unique set of changes in urine biomarkers.

• For example, there were worse tubular injury (higher interleukin [IL]-18), proximal tubular reabsorptive dysfunction (higher α1-microglobulin), tubular reserve (lower uromodulin) and immune response to injury (higher chitinase-3-like protein-1 [YKL-40]) in correlation with baseline hemoglobin A1c.

• In addition, a correlation of increasing hemoglobin A1c at follow-up was observed with further worsening of tubular injury (higher kidney injury molecule-1 [KIM-1] and IL-18) and higher YKL-40.

• Worsening proximal tubular reabsorptive dysfunction (higher β2-microglobulin [β2m]), and higher YKL-40 was observed in correlation with HCV co-infection, whereas worsening of markers of tubular and glomerular injury (higher KIM-1 and albuminuria, respectively) was observed in correlation with HIV viremia.