Microalbuminuria is associated with all-cause and AIDS mortality in women with HIV infection.
OBJECTIVE
Prevalence of microalbuminuria is increased in patients with HIV. Microalbuminuria is associated with increased mortality in other populations, including diabetics, for whom microalbuminuria testing is standard of care. We investigated whether microalbuminuria is associated with mortality in HIV-infected women not receiving antiretroviral therapy.


METHODS
Urinalysis for proteinuria and semiquantitative testing for microalbuminuria were performed in specimens from 2 consecutive visits in 1547 HIV-infected women enrolled in the Women's Interagency HIV Study in 1994-1995. Time to death was modeled using proportional hazards analysis.


RESULTS
Compared with women without albuminuria, the hazard ratio (HR) for all-cause mortality was increased in women with 1 (HR: 3.4; 95% CI: 2.2 to 5.2) or 2 specimens positive for either proteinuria or microalbuminuria (HR: 3.9; 95% CI: 2.1 to 7.0). The highest risk was observed in women with both specimens positive for proteinuria (HR: 5.8; 95% CI: 3.4 to 9.8). The association between albuminuria and all-cause mortality risk remained significant after adjustment for demographics, HIV disease severity, and related comorbidities. Similar results were obtained for AIDS death.


CONCLUSIONS
We identified a graded relationship between albuminuria and the risk of all-cause and AIDS mortality.
Wyatt
Christina M
CM
Department of Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA. christina.wyatt@mssm.edu
Hoover
Donald R
DR
Shi
Qiuhu
Q
Seaberg
Eric
E
Wei
Catherine
C
Tien
Phyllis C
PC
Karim
Roksana
R
Lazar
Jason
J
Young
Mary A
MA
Cohen
Mardge H
MH
Klotman
Paul E
PE
Anastos
Kathryn
K
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000401:mortality* / Q000473:pathology*; D000328:Adult; D000419:Albuminuria / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D016019:Survival Analysis