A5067435702- HIV-related health complications and treatments
- HIV/AIDS drug development and treatment
- Chronic Kidney Disease and Diabetes
- Dialysis and Renal Disease Management
- HIV/AIDS Research and Interventions
- Blood Pressure and Hypertension Studies
- Sepsis Diagnosis and Treatment
- Pneumocystis jirovecii pneumonia detection and treatment
- Acute Kidney Injury Research
- COVID-19 Clinical Research Studies
- Metabolism and Genetic Disorders
- HIV Research and Treatment
- Folate and B Vitamins Research
- COVID-19 and healthcare impacts
- Organ Transplantation Techniques and Outcomes
- Renal Transplantation Outcomes and Treatments
- Intensive Care Unit Cognitive Disorders
- Mitochondrial Function and Pathology
- Heart Failure Treatment and Management
- Cardiac Ischemia and Reperfusion
- Hormonal Regulation and Hypertension
- Liver Disease and Transplantation
- Renal Diseases and Glomerulopathies
- Muscle and Compartmental Disorders
- Venous Thromboembolism Diagnosis and Management
University of California, San Francisco
2015-2024
San Francisco VA Health Care System
2017-2024
San Francisco VA Medical Center
2011-2023
University of California System
2011
Chronic kidney disease (CKD) causes substantial global morbidity and increases cardiovascular all-cause mortality. Unlike other chronic diseases with established strategies for screening, there has been no consensus on whether health systems governments should prioritize early identification intervention CKD. Guidelines evaluating managing CKD are available but have not universally adopted in the absence of incentives or quality measures prioritizing care. The burden falls disproportionately...
Observational evidence suggests that higher physical activity is associated with slower kidney function decline; however, to our knowledge, no large trial has evaluated whether and exercise can ameliorate decline in older adults.
eGFR and albuminuria primarily reflect glomerular function injury, whereas tubule cell atrophy interstitial fibrosis on kidney biopsy are important risk markers for CKD progression. Kidney injury have been studied in hospitalized AKI. Here, we examined the association between urinary at baseline with subsequent loss of persons nondiabetic who participated Systolic Blood Pressure Intervention Trial (SPRINT).Among 2428 SPRINT participants (eGFR<60 ml/min per 1.73 m2) baseline, measured urine...
Abstract Aims Biomarkers of kidney tubule injury, inflammation and fibrosis have been studied extensively established as risk markers adverse cardiovascular disease (CVD) outcomes. However, associations tubular function with clinical events not well studied, especially in persons chronic (CKD). Methods results Using a sample 2377 CKD at the baseline Systolic Blood Pressure Intervention Trial (SPRINT) visit, we evaluated association three urine markers, alpha-1 microglobulin (α1m), beta-2...
Despite advances in therapy, HIV-infected individuals remain at higher risk for kidney dysfunction than uninfected individuals. It was hypothesized that urine levels of α1-microglobulin, a biomarker proximal tubular dysfunction, would predict function decline and mortality women.In the Women's Interagency HIV Study, α1-microglobulin creatinine concentrations were measured 903 287 women using stored from 1999 to 2000, when prevalence tenofovir use <1%. Participants categorized into three...
Cardiovascular risk remains high in kidney transplant recipients (KTRs) despite improved function after transplant. Urinary markers of fibrosis and injury may help to reveal mechanisms this risk. In a case–cohort study among stable KTRs who participated the FAVORIT trial, we measured four urinary proteins known correlate with tubulointerstitial on biopsy (urine alpha 1 microglobulin [α1m], monocyte chemoattractant protein-1 [MCP-1], procollagen type I [PINP] III [PIIINP] N-terminal amino...
Chronic kidney disease is a strong risk factor for cardiovascular (CVD), but clinical measures (estimated glomerular filtration rate and albuminuria) do not fully reflect the multiple aspects of tubules influencing health. Applied methods are needed to integrate numerous tubule biomarkers into useful prognostic scores. In SPRINT (Systolic Blood Pressure Intervention Trial) participants with chronic at baseline cr&cys <60 mL/minute per 1.73 m 2 ), we measured 8 from urine (α1M [α1M...
Kidney tubular atrophy on biopsy is a strong predictor of chronic kidney disease (CKD) progression, but health poorly quantified by traditional measures including estimated glomerular filtration rate (eGFR) and albuminuria. We hypothesized that urinary biomarkers impaired tubule function would be associated with faster eGFR declines in persons CKD.We measured baseline urine concentrations uromodulin, β2-microglobulin (β2m), α1-microglobulin (α1m) among 2,428 participants the Systolic Blood...
Tenofovir disoproxil fumarate (tenofovir) is associated with elevated concentrations of biomarkers kidney damage and dysfunction in individuals HIV. The relationship these longitudinal function decline unknown.We evaluated associations 14 urinary injury changes eGFR among 198 men women HIV who initiated tenofovir between 2009 2015 the Multicenter AIDS Cohort Study Women's Interagency Study. Urinary included albumin-to-creatinine ratio, α-1-microglobulin, β-2-microglobulin, cystatin C,...
Background The antiretroviral medication, tenofovir disoproxil fumarate ( TDF ), is used by most human immunodeficiency virus–infected persons in the United States despite higher risks of chronic kidney disease. Although disease a strong risk factor for heart failure HF association with incident unclear. Methods and Results We identified 21 435 patients Veterans Health Administration actively using antiretrovirals between 2002 2011. excluded prior diagnosis . was analyzed categorically...
Pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) is becoming increasingly adopted for HIV prevention. Tenofovir can cause proximal tubular damage chronic kidney disease in HIV-infected persons, but little known regarding its nephrotoxic potential among HIV-uninfected persons. In this study, we evaluated the effects of PrEP on urine levels following: α1-microglobulin (α1m), a marker impaired reabsorption; albuminuria, measure glomerular injury;...
Kidney tubulointerstitial fibrosis on biopsy is a strong predictor of chronic kidney disease (CKD) progression, and CKD associated with elevated risk cardiovascular (CVD). Tubular health poorly quantified by traditional function measures, including estimated glomerular filtration rate (eGFR) albuminuria. We hypothesized that urinary biomarkers tubular injury, inflammation, repair would be higher CVD mortality in persons CKD.We measured concentrations interleukin-18 (IL-18), injury...
In HIV-infected women, urine concentrations of novel tubulointerstitial injury markers, interleukin-18 (IL-18) and kidney marker-1 (KIM-1), are associated with function decline all-cause mortality. We hypothesized that individuals preserved filtration would have more extensive injury, as determined by compared to the uninfected controls, risk factors for differ from albuminuria.In this cross-sectional study, we IL-18, KIM-1 albumin-to-creatinine ratio (ACR) in 908 289 HIV-uninfected women...
Although individual urine biomarkers are associated with chronic kidney disease (CKD) incidence and all-cause mortality in the setting of HIV infection, their combined utility for prediction remains unknown.We measured eight shown previously to be incident CKD risk among 902 HIV-infected women Women's Interagency Study: N-acetyl-β-d-glucosaminidase (NAG), injury molecule-1 (KIM-1), alpha-1 microglobulin (α1m), interleukin 18, neutrophil gelatinase-associated lipocalin, albumin-to-creatinine...
Chronic kidney disease (CKD) is common among HIV-infected individuals but serum creatinine insensitive for detecting damage at early stages. We hypothesized that HIV infection would be associated with elevations in subclinical markers of injury and fibrosis a contemporary cohort men.In this cross-sectional study, we measured urine levels interleukin-18 (IL-18), molecule-1 (KIM-1), pro-collagen type III N-terminal pro-peptide (PIIINP) albumin-creatinine ratio (ACR) 813 331 uninfected men...
Tenofovir disoproxil fumarate (TDF) can cause kidney damage, but current clinical tests are insensitive for detecting toxicity. Among 884 HIV-infected men enrolled in the Multicenter AIDS Cohort Study, we measured urine biomarkers specific tubular damage (interleukin-18, injury molecule-1, procollagen type III N-terminal propeptide) and albuminuria. In adjusted analyses, each year of TDF exposure was independently associated with 3.3% higher interleukin-18 (95% CI: 0.8% to 5.8%), 3.4%...
<b><i>Background:</i></b> HIV-infected (HIV+) persons are at increased risk of chronic kidney disease, but serum creatinine does not detect early losses in function. We hypothesized that urine biomarkers damage would be associated with subsequent changes function a contemporary cohort HIV+ and HIV-uninfected (HIV–) men. <b><i>Methods:</i></b> In the Multicenter AIDS Cohort Study, we measured baseline concentrations 5 from 2009 to 2011 860 337...