title: The role of albuminuria in the follow-up of HIV-infected pediatric patients.
abstract: BACKGROUND
  In HIV-infected adults, elevated albumin has been associated with increased inflammatory activity, HIV-related nephropathy, and type 2 diabetes. Data on albuminuria in HIV-infected children are very scarce, and guidelines do not include routine determination of urinary albumin/creatinine ratio in this population.
  
  
  METHODS
  We performed a cross-sectional study in a cohort of HIV-infected pediatric patients. Urinary protein/creatinine and albumin/creatinine ratios and hematuria were determined from at least three morning urine samples, and glomerular filtration rate (GFR) was estimated from creatinine levels. Persistent renal damage was defined according to the presence of at least two sequentially abnormal values in one of the parameters. The relationship between renal damage, HIV-related variables, and metabolic comorbidities (dyslipidemia, fat redistribution, glucose intolerance, hypertension) was investigated.
  
  
  RESULTS
  Symptom-free renal damage was observed in 13 of 68 patients (19.1%) and mainly consisted of persistent proteinuria (17.6%); glomerular proteinuria was twice as prevalent as tubular proteinuria. GFR were normal in all cases. No relationship between renal markers and HIV-related variables or metabolic comorbidities was observed.
  
  
  CONCLUSIONS
  Mild proteinuria affected approximately one fifth of patients in our cohort. The determination of albuminuria allowed the differentiation between glomerular and tubular proteinuria, although no relationship with metabolic comorbidities was observed.
authors.affiliation: Infectious Diseases Unit, Pediatrics Department - Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig Sant Joan de Déu 2, 08950, Esplugues, Barcelona, Spain.
authors.forename: Angela
authors.initials: A
authors.lastname: Deyà-Martínez
authors.forename: Antoni
authors.initials: A
authors.lastname: Noguera-Julian
authors.forename: Jordi
authors.initials: J
authors.lastname: Vila
authors.forename: Anna
authors.initials: A
authors.lastname: Vila
authors.forename: Anna
authors.initials: A
authors.lastname: Valls
authors.forename: Emília
authors.initials: E
authors.lastname: Sánchez
authors.forename: Rafael
authors.initials: R
authors.lastname: Jiménez
authors.forename: Clàudia
authors.initials: C
authors.lastname: Fortuny
mesh_terms: D016263:AIDS-Associated Nephropathy / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology*; D000293:Adolescent; D000419:Albuminuria / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D015658:HIV Infections / Q000150:complications; D006801:Humans; D008297:Male; D011507:Proteinuria / Q000453:epidemiology / Q000209:etiology
references.citation: Arch Pediatr Adolesc Med. 2009 Feb;163(2):164-71
references.pmid: 19188649
references.citation: HIV Med. 2012 Oct;13(9):526-32
references.pmid: 22413854
references.citation: Pediatrics. 2004 Aug;114(2 Suppl 4th Report):555-76
references.pmid: 15286277
references.citation: Pediatr Nephrol. 2013 Jul;28(7):1145-9
references.pmid: 23503768
references.citation: Pediatr Nephrol. 1995 Aug;9(4):428-30
references.pmid: 7577402
references.citation: Pediatr Nephrol. 1996 Oct;10(5):598-601
references.pmid: 8897564
references.citation: J Pediatr. 2008 Jun;152(6):844-9
references.pmid: 18492529
references.citation: J Pediatr. 1985 Mar;106(3):522-6
references.pmid: 3973793
references.citation: Diabetes. 1998 May;47(5):793-800
references.pmid: 9588452
references.citation: Horm Res Paediatr. 2011;76(6):386-91
references.pmid: 22042056
references.citation: Nephrol Dial Transplant. 2011 Dec;26(12):3923-9
references.pmid: 21427068
references.citation: An Pediatr (Barc). 2008 Jun;68(6):552-69
references.pmid: 18559194
references.citation: Niger J Med. 2010 Jul-Sep;19(3):298-301
references.pmid: 20845635
references.citation: Curr Opin Nephrol Hypertens. 2009 May;18(3):246-51
references.pmid: 19276802
references.citation: Metabolism. 2011 Jun;60(6):874-80
references.pmid: 20947103
references.citation: Am J Kidney Dis. 2010 Nov;56(5):872-82
references.pmid: 20709438
references.citation: J Trop Pediatr. 2010 Jun;56(3):187-90
references.pmid: 19793893
references.citation: AIDS. 2007 May 11;21(8):1003-9
references.pmid: 17457094
references.citation: PLoS One. 2011;6(9):e24610
references.pmid: 21931772
references.citation: J Hypertens. 2013 Nov;31(11):2230-6; discussion 2236
references.pmid: 24096259
references.citation: AIDS. 2013 May 15;27(8):1295-302
references.pmid: 23925378
references.citation: Pediatr Infect Dis J. 2009 Jul;28(7):619-25
references.pmid: 19561425
references.citation: Nephrol Dial Transplant. 2012 Apr;27(4):1534-41
references.pmid: 22193048
references.citation: HIV Med. 2010 Aug;11(7):419-26
references.pmid: 20059571