Department of Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA.
J Acquir Immune Defic Syndr. 2010 Sep;55(1):73-7. doi: 10.1097/QAI.0b013e3181cc1070.
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.
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.
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.
We identified a graded relationship between albuminuria and the risk of all-cause and AIDS mortality.
HIV 感染者的微量白蛋白尿患病率增加。微量白蛋白尿与其他人群（包括糖尿病患者）的死亡率增加相关，对于这些人群，微量白蛋白尿检测是标准的护理措施。我们调查了未接受抗逆转录病毒治疗的 HIV 感染女性中微量白蛋白尿与死亡率之间的关系。
在 1994-1995 年参加妇女艾滋病机构间研究的 1547 名 HIV 感染女性的 2 次连续就诊的标本中进行尿蛋白和微量白蛋白尿的半定量检测。使用比例风险分析来建模死亡时间。
与无白蛋白尿的女性相比，1 个（HR：3.4；95%CI：2.2 至 5.2）或 2 个标本同时出现蛋白尿或微量白蛋白尿阳性的女性全因死亡率的危险比（HR）升高（HR：3.9；95%CI：2.1 至 7.0）。在同时 2 个标本均出现蛋白尿的女性中观察到最高风险（HR：5.8；95%CI：3.4 至 9.8）。在校正人口统计学、HIV 疾病严重程度和相关合并症后，白蛋白尿与全因死亡率风险之间的关联仍然显著。全因死亡和 AIDS 死亡的结果相似。
我们确定了白蛋白尿与全因和 AIDS 死亡率风险之间存在分级关系。
