Search

ObjectivesIndividual kidney tubule biomarkers are associated with chronic kidney disease (CKD) risk in people living with HIV (PLWH). Whether a combination of kidney biomarkers can be integrated into informative summary scores for PLWH is unknown.MethodsWe measured eight urine biomarkers of kidney tubule health at two visits over a 3-year period in 647 women living with HIV in the Women's Interagency Health Study. We integrated biomarkers into factor scores using exploratory factor analysis. We evaluated associations between CKD risk factors and factor scores, and used generalized estimating equations to determine associations between factor scores and risk of incident CKD.ResultsFactor analysis identified two unique factor scores: a tubule reabsorption score comprising alpha-1-microglobulin, beta-2-microglobulin and trefoil factor-3; and a tubule injury score comprising interleukin-18 and kidney injury molecule-1. We modelled the two factor scores in combination with urine epidermal growth factor (EGF) and urine albumin. Predominantly HIV-related CKD risk factors were independently associated with worsening tubule reabsorption scores and tubule injury scores. During a median follow-up of 7 years, 9.7% (63/647) developed CKD. In multivariable time-updated models that adjusted for other factor scores and biomarkers simultaneously, higher tubule reabsorption scores [risk ratio (RR) = 1.27, 95% confidence interval (CI): 1.01-1.59 per 1 SD higher time-updated score], higher tubule injury scores (RR = 1.36, 95% CI: 1.05-1.76), lower urine EGF (RR = 0.75, 95% CI: 0.64-0.87), and higher urine albumin (RR = 1.20, 95% CI: 1.02-1.40) were jointly associated with risk of incident CKD.ConclusionsWe identified two novel and distinct dimensions of kidney tubule health that appear to quantify informative metrics of CKD risk in PLWH.

Proteinuria is associated with adverse clinical outcomes in HIV infection. Here we evaluated whether APOL1 risk alleles, previously associated with advanced kidney disease, are independently associated with proteinuria in HIV infection in a cross-sectional

María Julieta Russo,1 Gabriela Cohen,1 Patricio Chrem Mendez,1 Jorge Campos,1 Federico E Nahas,1 Ezequiel I Surace,1 Silvia Vazquez,1 Deborah Gustafson,2,3 Salvador Guinjoan,1 Ricardo F Allegri,1 Gustavo Sevlever1 On behalf of the Argentina-Alzheimer’s Disease Neuroim­aging Initiative group 1Center of Aging and Memory of Neurological Research Institute (FLENI), Buenos Aires, Argentina; 2Department of Neurology, State University of New York-Downstate Medical Center, Brooklyn, NY, USA; 3Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenPurpose: Argentina-Alzheimer’s Disease Neuroimaging Initiative (Arg-ADNI) is the first ADNI study to be performed in Latin America at a medical center with the appropriate infrastructure. Our objective was to describe baseline characteristics and to examine whether biomarkers related to Alzheimer’s disease (AD) physiopathology were associated with worse memory performance.Patients and methods: Fifteen controls and 28 mild cognitive impairment and 13 AD dementia subjects were included. For Arg-ADNI, all biomarker parameters and neuropsychological tests of ADNI-II were adopted. Results of positron emission tomography (PET) with fluorodeoxyglucose and 11C-Pittsburgh compound-B (PIB-PET) were available from all participants. Cerebrospinal fluid biomarker results were available from 39 subjects.Results: A total of 56 participants were included and underwent baseline evaluation. The three groups were similar with respect to years of education and sex, and they differed in age (F=5.10, P=0.01). Mean scores for the baseline measurements of the neuropsychological evaluation differed significantly among the three groups at P0.1). Baseline amyloid deposition and left hippocampal volume separated the three diagnostic groups and correlated with the memory performance (P

Summary: Oral omeprazole is used in the management of equine gastric ulcer syndrome (EGUS). However, its use may have limitations with regard to individual variation in absorption and the impact of dietary management on bioavailability. The objective of this study was to determine whether a novel compounded long‐acting injectable omeprazole (LAO‐USA) formulation would provide consistent serum omeprazole concentrations and to determine whether it was clinically safe and efficacious in the reduction of EGUS. Twenty‐three horses with EGUS described as having evidence of equine squamous gastric disease (ESGD) and/or equine glandular gastric disease (EGGD) received a 5 mg/kg bwt intramuscular injection of LAO‐USA once every 7 days for four doses. Gastroscopy was performed prior to the study and at Days 14 and 28. Pharmacokinetic analysis was performed to determine omeprazole concentrations over 7 days. Safety was measured by monitoring injection site reactions daily and bloodwork screening prior to and following the study. Of the horses with ESGD, 78% had improvement by Day 14 (p = 0.0035), with no further improvement from Day 14 to 28 (p > 0.99). ESGD grades from Day 0 to 28 decreased significantly (95% CI −1.92 to −0.91 grades) (p = 0.0002). Out of the horses (6/23) that had glandular lesions, 5/6 healed over time; however, this was not a significant change (p = 0.75). Injection reactions included oedema, heat and pain at the injection site. Considering the total number of injections across the whole study, 23% of horses experienced an injection site reaction. The number of injection site reactions increased following each dose (8%, 13%, 22% and 48%, respectively). The formulation did not appear to have adverse systemic effects. Serum omeprazole mean Cmax was 46.2 ng/ml (±17.4 ng/ml), and these concentrations maintained at approximately 9.6 ng/ml (±4.6 ng/ml) for 7 days following dosing. This formulation is compounded and has not completed FDA investigation, which may increase formulation variability as it is produced or stored. The lack of control groups and potential bias in lesion grading are additional recognised limitations. The results of this study provide preliminary safety and efficacy data with regard to a novel LAO‐USA formulation. Future study is warranted to describe safety and efficacy for both ESGD and EGGD and would support further FDA investigation. [ABSTRACT FROM AUTHOR]