Kidney Week

Abstract: FR-PO1164

Associations of Repeated Measures of Plasma Biomarkers of Kidney Tubular Health with Kidney Function Decline in People with HIV

Session Information

• CKD: Screening, Diagnosis, Serum and Urine Biomarkers, and Scoring Indices
  November 07, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Fisher, Molly, Albert Einstein College of Medicine, New York, New York, United States

Molly Fisher, DO, MS, FASN

• Scherzer, Rebecca, University of California San Francisco, San Francisco, California, United States

Rebecca Scherzer, PhD

• Postalcioglu, Merve, University of California San Francisco, San Francisco, California, United States

Merve Postalcioglu, MD

• Chen, Teresa K., University of California San Francisco, San Francisco, California, United States

Teresa K. Chen, MD

• Ascher, Simon, University of California Davis, Davis, California, United States

Simon Ascher, MD, MPH

• Shlipak, Michael, University of California San Francisco, San Francisco, California, United States

Michael Shlipak, MD, MPH

• Estrella, Michelle M., University of California San Francisco, San Francisco, California, United States

Michelle M. Estrella, MD, MHS

Group or Team Name

• On behalf of the Multicenter AIDS Cohort Study and Women's Interagency HIV Study.

Background

It is unknown if plasma biomarkers of kidney tubular health can capture associations of kidney function decline in people with HIV (PWH).

Methods

We conducted a case-cohort study of 440 PWH in the Women’s Interagency HIV Study and Multicenter AIDS Cohort Study. Cases developed rapid kidney function decline (RKFD: ≥30% eGFR reduction). We measured plasma biomarkers of tubular injury (KIM-1), inflammation (TNFr1, TNFr2), and synthetic function (UMOD, EGF) at baseline and year 2. Multivariable risk regression evaluated associations of baseline, year 2 and 2-year changes in each biomarker with RKFD with follow up beginning at year 2 and ending at year 7. LASSO regression determined if any biomarkers were jointly associated with RKFD. In a subcohort comprising a representative sample of the full cohort, linear mixed effects models assessed biomarker associations with annualized eGFR change from year 2 to year 7. Models were adjusted for sociodemographics, comorbidities, HIV-related factors, eGFR, and albuminuria.

Results

At baseline, median age was 49 years, 33% were women, 69% were virally suppressed, and eGFR was similar in cases vs. non-cases (93 vs. 94 mL/min/1.73m²). Over a median follow-up of 4.5 years, 172 PWH developed RKFD. In multivariable models, each 1-standard deviation (SD) higher baseline level of KIM-1, TNFr1, TNFr2, UMOD, and EGF was independently associated with relative risks (RR) for RKFD of 1.23, 1.33, 1.38, 0.86, and 0.86, respectively. Associations of year 2 and 2-year changes in biomarker levels with RKFD were similar (Figure). Baseline KIM-1, TNFr2, and UMOD were selected by LASSO as jointly associated with RR for RKFD of 1.15, 1.27, and 0.88, respectively. In the sub-cohort, none of the baseline, year 2, or 2-year changes in biomarkers were associated with annualized eGFR change.

Conclusion

In PWH, repeated measures of plasma biomarkers reflecting impaired kidney tubular health are independently associated with RKFD. These biomarkers may be useful in identifying PWH at risk of adverse kidney outcomes.

Funding

• Other NIH Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025tbary63k