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Kidney Week

Abstract: PO0426

Increased Circulating suPAR Levels in African Patients with HIV

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Wei, David Changli, Rush University Medical Center, Chicago, Illinois, United States
  • Samelko, Beata, Rush University Medical Center, Chicago, Illinois, United States
  • Zeier, Martin G., University Hospital Heidelberg, Heidelberg, Germany
  • Parekh, Rulan S., University of Toronto, Toronto, Ontario, Canada
  • Reiser, Jochen, Rush University Medical Center, Chicago, Illinois, United States
Background

Decline in kidney function associated with APOL1 risk alleles is dependent on circulating suPAR levels in African American (AA) patients. Yet, little is known among HIV infected persons in sub-Saharan Africa, and epidemiological data from this region regarding APOL1 risk status is scarce. We aimed to determine APOL1 risk variants, plasma suPAR levels and estimated kidney function in HIV patients in Zambia.

Methods

We performed a cross-sectional study with 480 adult HIV infected persons on anti-retroviral treatment (ART) (women, 64.8%) in Lusaka, Zambia. APOL1 genotyping was done to determine the prevalence of the risk alleles; plasma suPAR levels were assayed and estimated GFR (eGFR) was calculated by CKD-EPI creatinine-based formula.

Results

Plasma suPAR levels were increased and were negatively correlated to eGFR, whether less than 60 or not (r=-0.15, p=0.001). Women while younger (42 vs 46 years old for men, p=0.0003), had higher suPAR than men (3.68 ng/ml vs 3.07 ng/ml, p<0.0001). Ten out of 480 patients (2.1%) had CKD, and their suPAR levels were higher than patients without CKD (5.6 ng/ml vs 3.44 ng/ml, p<0.0001). Fifty patients (10.4%) had 2 APOL1 risk alleles (35 for women vs 15 for men); among those, 3 (6%) developed CKD (p=0.07). No difference in suPAR levels or eGFR was observed between patients who carried 2 APOL1 risk alleles and those with 1 or 0 risk allele.

Conclusion

HIV infected persons in Zambia on ART have increased suPAR levels. The prevalence of two APOL1 risk alleles is similar as with AA HIV patients. A longitudinal study with a bigger cohort should reveal the relationship between suPAR, APOL1 risk alleles and kidney function.

Funding

  • NIDDK Support