Abstract: FR-PO1143
Albuminuria Testing and Prevalence in a Clinic-Based Cohort of People with HIV in the Bronx
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
- Tandoh, Buadi Kofi, Montefiore Einstein Medical Center, New York, New York, United States
- Johns, Tanya S., Montefiore Einstein Medical Center, New York, New York, United States
- Fazzari, Melissa, Albert Einstein College of Medicine, New York, New York, United States
- Ross, Michael J., Montefiore Einstein Medical Center, New York, New York, United States
- Fisher, Molly, Montefiore Einstein Medical Center, New York, New York, United States
Background
Albuminuria testing is critical for early detection of chronic kidney disease (CKD) and initiation of evidence-based therapies, but it is underused in clinical practice, even among high-risk individuals. People with HIV (PWH) are at increased risk for CKD from both HIV-related and traditional risk factors. We aimed to determine the prevalence of albuminuria testing in PWH and develop a model to estimate increased albuminuria in those untested.
Methods
We conducted an observational study of PWH receiving outpatient care (≥2 visits/year) within a large Bronx health system between 2015-2024. We assessed the prevalence of urine albumin/creatinine ratio (UACR) testing overall and across subgroups. A logistic regression model estimated the probability of testing, adjusting for demographic (age, sex, race, smoking, illicit drugs), hypertension, diabetes, cardiovascular disease, eGFR, HIV-related factors (CD4, viral load, tenofovir disoproxil fumarate (TDF)), and nephrology care. Inverse probability weights from this model were then incorporated into a second multivariable logistic regression model to identify predictors of albuminuria (UACR ≥30 mg/g) among those tested. Both models included the same set of covariates. The fitted model was then applied to untested PWH to estimate their risk of albuminuria.
Results
Among 8,282 PWH (median age 50 years; 41% female; 90% Black or Hispanic), 19.8% had diabetes, 43.7% had hypertension, 10.1% had CKD and 69% were virally suppressed. Only 1,246 (15%) had UACR testing, of whom 41.7% had a UACR ≥30 mg/g. Testing was lowest (10.6%) in those with CD4 <200, yet albuminuria was 61.2% in this group. Among untested PWH, estimated prevalence of albuminuria was 27.8%. Overall, fewer than one-third (29.9%) of those projected to have albuminuria had been tested. In adjusted models, diabetes (aOR 1.66), TDF (aOR 1.70) and smoking (aOR 1.38) were independently associated with higher odds of albuminuria, while viral suppression (aOR 0.66), CD4 >200 (aOR 0.41) and higher eGFR (aOR per unit increase: 0.99) were independently associated with lower odds. Model discrimination was moderate (AUC 0.72).
Conclusion
Albuminuria was prevalent among PWH but often underrecognized due to lack of testing. These findings highlight the need for improved implementation of albuminuria screening in this high-risk population.