Kidney Week

Abstract: SA-OR001

Plasma Biomarkers of Kidney Tubule Health and Kidney Function Recovery After Ambulatory AKI in People with HIV

Session Information

• AKI Advances: Biomarkers, Outcomes, and Clinical Trials
  November 08, 2025 | Location: Room 320A, Convention Center
  Abstract Time: 04:30 PM - 04:40 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

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

Merve Postalcioglu, MD

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

Rebecca Scherzer, PhD

• Fisher, Molly, Montefiore Health System Inc, New York, New York, United States

Molly Fisher, DO, MS, FASN

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

Michelle M. Estrella, MD, MHS

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

Michael Shlipak, MD, MPH

Group or Team Name

• MWCCS.

Background

People with HIV (PWH) are at excess risk of AKI. We examined whether plasma biomarkers of kidney tubule health measured at baseline and at the time of ambulatory AKI are associated with subsequent eGFR recovery.

Methods

We conducted a nested inception cohort study of PWH within the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study. The index visit was the time of ambulatory AKI, defined as the first documented rise in sCr≥0.3mg/dL relative to baseline (6 or 12 months prior). Plasma biomarkers of tubular synthetic function (UMOD and EGF), inflammation (TNFR1 and TNFR2), and injury (KIM-1) were measured at both time points. Linear regression was used to evaluate associations of biomarkers with percent eGFR recovery over the subsequent year after ambulatory AKI. A parsimonious set of biomarkers selected by LASSO were modeled to examine their joint associations with eGFR recovery. Models were adjusted for demographics, traditional kidney disease risk factors, HIV-related factors, eGFR, and UACR.

Results

Among 211 PWH with ambulatory AKI, median age was 54 years (IQR: 48,60); median eGFR was 55 ml/min/1.73m² (IQR: 41,67); and UACR was 22 mg/g (IQR: 7,109). The median eGFR change 1-year after AKI was +15.6 ml/min/1.73m². In adjusted models, higher baseline KIM-1 was associated with less eGFR recovery. At the index visit, higher TNFR1, TNFR2, and KIM-1 were associated with less recovery, while higher UMOD was associated with greater recovery (Figure). Biomarkers at the index visit that were selected by LASSO as jointly associated with eGFR recovery included: UMOD (β=9%, 95%CI:1%,18%), TNFR2 (β=-11%, 95%CI:-22%,1%), and KIM-1 (β=-10, 95%CI:-20%,1%).

Conclusion

Plasma biomarkers reflecting multiple dimensions of kidney tubule health are associated with eGFR recovery after ambulatory AKI and may be useful for prognostication in this setting.

Funding

• Other NIH Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025ragmwmmw