ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2016
HIV Infection, Tenofovir, and Urine α1-Microglobulin: A Cross-sectional Analysis in the Multicenter AIDS Cohort Study.
Article in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Chronic kidney disease among people living with HIV on TDF based regimen: A systematic review and meta-analysis.PloS one · 2025Pooled it
- The SPRINT trial suggests that markers of tubule cell function in the urine associate with risk of subsequent acute kidney injury while injury markers elevate after the injury.Kidney international · 2019Trial
- Pre-exposure Prophylaxis With Tenofovir Disoproxil Fumarate/Emtricitabine and Kidney Tubular Dysfunction in HIV-Uninfected Individuals.Journal of acquired immune deficiency syndromes (1999) · 2018Trial
- Proximal tubule reabsorptive dysfunction and risk of cardiovascular death among community-living adults: the HUNT-3 cohort.European heart journal open · 2026Article
- Pegylated interferon-α-2b add-on therapy to renal function for chronic hepatitis B patients who were treated with tenofovir disoproxil fumarate: a retrospective real-world study.Virology journal · 2026Observational
- Urine Tubular Biomarkers Are Associated With Natriuresis in Patients With Acute Heart Failure.Journal of the American Heart Association · 2025Article
- Urine Epidermal Growth Factor and Kidney Function Decline in Middle-Aged Adults.Kidney medicine · 2024Article
- Article
- Biomarkers of Kidney Tubule Disease and Risk of End-Stage Kidney Disease in Persons With Diabetes and CKD.Kidney international reports · 2022Article
- The Promise of Tubule Biomarkers in Kidney Disease: A Review.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2021Review
- Urinary biomarkers of early renal injury in antiretroviral-naïve HIV-positive persons in Shanghai, China: comparison with the general population.HIV medicine · 2021Article
- Associations of CKD risk factors and longitudinal changes in urine biomarkers of kidney tubules among women living with HIV.BMC nephrology · 2021Article
- Kidney tubule health scores and their associations with incident CKD in women living with HIV.HIV medicine · 2021Article
- HIV preexposure prophylaxis with tenofovir disoproxil fumarate/emtricitabine and changes in kidney function and tubular health.AIDS (London, England) · 2020Article
- Association of Statin Use With Kidney Damage and Function Among HIV-Infected Men.Journal of acquired immune deficiency syndromes (1999) · 2019Article
- Tenofovir disoproxil fumarate initiation and changes in urinary biomarker concentrations among HIV-infected men and women.AIDS (London, England) · 2019Observational
- Biomarkers of Acute and Chronic Kidney Disease.Annual review of physiology · 2019Review
- Review
- Associations of Urine Biomarkers with Kidney Function Decline in HIV-Infected and Uninfected Men.American journal of nephrology · 2019Article
- Long-term kidney function, proteinuria, and associated risks among HIV-infected and uninfected men.AIDS (London, England) · 2018Article
Corrections and comments
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Authors and funding
11 authors at 10 institutions in 1 country.
Funding
Abstract
backgroundTenofovir disoproxil fumarate (TDF) can cause proximal tubular damage and chronic kidney disease in human immunodeficiency virus (HIV)-infected individuals. Urine α1-microglobulin (A1M), a low-molecular-weight protein indicative of proximal tubular dysfunction, may enable earlier detection of TDF-associated tubular toxicity. STUDY
designCross-sectional. SETTING &
participants883 HIV-infected and 350 -uninfected men enrolled in the Multicenter AIDS Cohort Study. PREDICTORS: HIV infection and TDF exposure. OUTCOME: Urine A1M level.
resultsUrine A1M was detectable in 737 (83%) HIV-infected and 202 (58%) -uninfected men (P<0.001). Among HIV-infected participants, 573 (65%) were current TDF users and 112 (13%) were past TDF users. After multivariable adjustment including demographics, traditional kidney disease risk factors, and estimated glomerular filtration rate, HIV infection was associated with 136% (95% CI, 104%-173%) higher urine A1M levels and 1.5-fold (95% CI, 1.3- to 1.6-fold) prevalence of detectable A1M. When participants were stratified by TDF exposure, HIV infection was associated with higher adjusted A1M levels, by 164% (95% CI, 127%-208%) among current users, 124% (95% CI, 78%-183%) among past users, and 76% (95% CI, 45%-115%) among never users. Among HIV-infected participants, each year of cumulative TDF exposure was associated with 7.6% (95% CI, 5.4%-9.9%) higher A1M levels in fully adjusted models, a 4-fold effect size relative to advancing age (1.8% [95% CI, 0.9%-2.7%] per year). Each year since TDF treatment discontinuation was associated with 4.9% (95% CI, -9.4%--0.2%) lower A1M levels among past users. LIMITATIONS: Results may not be generalizable to women.
conclusionsHIV-infected men had higher urine A1M levels compared with HIV-uninfected men. Among HIV-infected men, cumulative TDF exposure was associated with incrementally higher A1M levels, whereas time since TDF treatment discontinuation was associated with progressively lower A1M levels. Urine A1M appears to be a promising biomarker for detecting and monitoring TDF-associated tubular toxicity.
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