Proteinuria and Elevated Creatinine Level in Women Is Associated with Increased Risk of Death and Development of AIDS-defining Illness

The associations of proteinuria and an elevated creatinine level with progression to AIDS and death in the era of HAART have not been fully described.

This analysis includes 2038 HIV-infected women from the Women's Interagency HIV Study. Time to the development of a newAIDS-defining illness (ADI) and death was modeled using proportional hazards regression before the widespread availability of HAART and after initiation of HAART.

Results

Of the 2038 subjects, the 14.1% of women with proteinuria had lower CD4 lymphocyte counts and higher viral loads (P < .0001 for all) at baseline and before initiation of HAART.

Before the widespread availability of HAART, proteinuria was associated with an increased risk for development of ADI, and proteinuria and an elevated creatinine level were both associated with an increased risk of death.

Among women initiating HAART, an elevated creatinine level remained associated with an increased risk of development of ADI, and proteinuria and an elevated creatinine level were associated with an increased risk of death.

Conclusions   

Proteinuria and an elevated creatinine level were associated with an increased risk of death and development of ADI. These associations may reflect the direct role of the kidney in modulating HIV disease, or they may act as markers of greater comorbidity.

10/15/04

Reference
L A Szczech and others. Association between Renal Disease and Outcomes among HIV-Infected Women Receiving or Not Receiving Antiretroviral Therapy. Clinical Infectious Diseases 39(8): 1199-1206. October 15, 2004.