Table 4.

Associations of urine α1-microglobulin with kidney function decline and mortality in HIV-infected women.

Incident CKD10% Decline in eGFRCysAll-Cause Mortality
C1C2C3C1C2C3C1C2C3
Range of α1m/cr (mg/g)—1.2–10.2>10.2—1.2–10.2>10.2—1.2–10.2>10.2
No. at risk343262214358272273358272273
No. events48507991735293663
Risk Ratio (95% CI)Risk Ratio (95% CI)Risk Ratio (95% CI)Risk Ratio (95% CI)Hazard Ratio (95% CI)Hazard Ratio (95% CI)
Demographic adjustedaReference1.35 (0.58 to 3.14)3.56 (2.16 to 5.88)Reference2.53 (1.14 to 5.64)4.53 (2.21 to 9.28)Reference1.60 (0.98 to 2.63)2.66 (1.70 to 4.17)
Multivariate adjustedb—1.31 (0.62 to 2.74)2.36 (1.42 to 3.92)—2.21 (1.01 to 4.84)2.99 (1.42 to 6.29)—1.47 (0.89 to 2.44)1.69 (1.06 to 2.69)
Adjusted+ACRc—1.34 (0.66 to 2.72)2.08 (1.28 to 3.38)—2.38 (1.11 to 5.12)2.70 (1.23 to 5.92)—1.50 (0.91 to 2.49)1.61 (1.00 to 2.59)
Adjusted+ACR, IL-18, KIM-1, NGALd—1.13 (0.65 to 1.98)1.87 (1.23 to 2.84)—2.68 (1.26 to 5.72)2.76 (1.28 to 5.98)—1.65 (0.98 to 2.76)1.73 (1.07 to 2.82)

  • Standardized to urine creatinine and stratified by categories. Category 1 comprises all participants with undetectable urine α1-microglobulin. All analyses use category 1 as the reference category. eGFRCys, cystatin C-based eGFR; C1, category 1; C2, category 2; C3, category 3; α1m/cr, α1–microglobulin-to-creatinine ratio; 95% CI, 95% confidence interval; ACR, albumin-to-creatinine ratio; KIM-1, kidney injury molecule-1; NGAL, neutrophil gelatinase-associated lipocalin.

  • ↵a Adjusted for age and race.

  • ↵b Adjusted for age, race, baseline eGFRCys, hypertension, diabetes mellitus, hepatitis C virus infection, HIV viral load, CD4 lymphocyte count, antiretroviral therapy use, and serum albumin.

  • ↵c Adjusted for all covariates listed above with the addition of ACR.

  • ↵d Adjusted for all covariates listed above with the addition of ACR, IL-18, KIM-1, NGAL, and liver fatty acid binding protein.