title: Increased prevalence of albuminuria in HIV-infected adults with diabetes.
abstract: OBJECTIVE
  HIV and type 2 diabetes are known risk factors for albuminuria, but no previous reports have characterized albuminuria in HIV-infected patients with diabetes.
  
  
  METHODS
  We performed a cross-sectional study including 73 HIV-infected adults with type 2 diabetes, 82 HIV-infected non-diabetics, and 61 diabetic control subjects without HIV. Serum creatinine >1.5 mg/dL was exclusionary. Albuminuria was defined as urinary albumin/creatinine ratio >30 mg/g.
  
  
  RESULTS
  The prevalence of albuminuria was significantly increased among HIV-infected diabetics (34% vs. 13% of HIV non-diabetic vs. 16% diabetic control, p = 0.005). HIV status and diabetes remained significant predictors of albuminuria after adjusting for age, race, BMI, and blood pressure. Albumin/creatinine ratio correlated significantly with HIV viral load (r = 0.28, p = 0.0005) and HIV-infected subjects with albuminuria had significantly greater cumulative exposure to abacavir (p = 0.01). In an adjusted multivariate regression analysis of HIV-infected subjects, the diagnosis of diabetes (p = 0.003), higher HIV viral load (p = 0.03) and cumulative exposure to abacavir (p = 0.0009) were significant independent predictors of albuminuria.
  
  
  CONCLUSIONS
  HIV and diabetes appear to have additive effects on albuminuria which is also independently associated with increased exposure to abacavir and HIV viral load. Future research on the persistence, progression and management of albuminuria in this unique at-risk population is needed.
authors.affiliation: National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Kim
authors.forename: Christian
authors.initials: C
authors.lastname: Woods
authors.forename: Lauren
authors.initials: L
authors.lastname: Dutcher
authors.forename: Patrick
authors.initials: P
authors.lastname: Georgoff
authors.forename: Alice
authors.initials: A
authors.lastname: Rosenberg
authors.forename: Jo Ann M
authors.initials: JA
authors.lastname: Mican
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Kopp
authors.forename: Margo A
authors.initials: MA
authors.lastname: Smith
authors.forename: Colleen
authors.initials: C
authors.lastname: Hadigan
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000453:epidemiology / Q000209:etiology*; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology*; D015224:Dideoxynucleosides / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D000099227:Abacavir
chemical_list: D019380:Anti-HIV Agents; D015224:Dideoxynucleosides; D000099227:Abacavir