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Researchers Find Increased Kidney Damage In People With Both HIV And Diabetes

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Published: Sep 22, 2011 9:19 am
Researchers Find Increased Kidney Damage In People With Both HIV And Diabetes

Researchers from the United States recently found an increased rate of kidney damage in people who have both HIV and diabetes compared to people with just HIV or just diabetes. The researchers also found that kidney damage was more common in people with higher viral loads.

“The important message from this study is to raise awareness about the high prevalence of albuminuria [a marker of kidney damage] among health care providers for individuals with HIV and diabetes,” said Dr. Colleen Hadigan, a researcher at the National Institute of Allergy and Infectious Diseases and senior author of the study.

“As this is an important marker of early kidney injury, it can be used to screen patients, and the standard of care for use of [blood pressure lowering] treatments in this setting in diabetes should be followed whenever possible in those with HIV and diabetes,” she added.

In addition, she said that people with HIV should make sure that their viral loads (amount of HIV in the blood) are well controlled with antiretroviral therapy.

Kidney disease occurs when the kidneys lose the ability to regulate the body’s fluids and filter the blood to eliminate waste products and toxic substances. As a result, water, waste, and toxins build up in the body. Chronic kidney disease is defined by evidence of kidney damage or decreased kidney function for at least three months.

Kidney disease can cause other health conditions such as heart disease, nerve damage, bone disease, and anemia (a decrease in red blood cells that prevents the body from getting enough oxygen).

The two most common causes of kidney disease are high blood pressure (hypertension) and diabetes, a condition in which the body cannot properly manage its blood sugar levels.

People with HIV are at an increased risk of kidney disease because the virus interferes with the kidneys’ ability to function correctly. People with advanced HIV who have a low CD4 (white blood cell) count and a high viral load are at greater risk for developing kidney disease. Older people with HIV are also at greater risk of kidney disease.

One indicator of kidney damage is a medical condition known as albuminuria. Albuminuria occurs when the protein albumin, a protein needed for the proper distribution of fluids within the body, is found in the urine.

According to the study authors, previous studies have shown that people with HIV are at a high risk for developing albuminuria. People with diabetes are also at higher risk of albuminuria.

Several recent studies have suggested that people with HIV may be at higher risk of diabetes due to long-term use of antiretroviral therapy, which is also associated with the development of kidney disease, high cholesterol, and heart disease. As a result, researchers have become increasingly concerned about the effects of diabetes in HIV-positive patients.

The authors in this study investigated the rate of albuminuria in 73 HIV-positive individuals with type 2 diabetes compared to 82 HIV-positive individuals without type 2 diabetes and 61 HIV-negative patients with type 2 diabetes.

Results showed that 34 percent of patients with HIV and diabetes had albuminuria, compared to 13 percent of HIV patients without diabetes and 16 percent of HIV-negative patients with diabetes.

Higher viral loads were associated with albuminuria in participants with HIV, both with and without diabetes. Additionally, HIV patients taking the antiretroviral drug Ziagen (abacavir) were more likely to have albuminuria compared to HIV patients not taking Ziagen.

Results also showed that participants with diabetes, with or without HIV, were older, weighed more, were more likely to be treated for high blood pressure, and were more often African-American compared to HIV patients without diabetes.

HIV-positive participants with diabetes were more likely to have untreated HIV compared to participants with HIV but without diabetes (15 percent versus 1 percent), were less likely to be on current antiretroviral treatment (77 percent versus 94 percent), and were less likely to have viral loads of less than 50 copies per milliliter of blood (56 percent versus 81 percent).

For more information, please see the study in PLoS One.

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