Kidney Week

Abstract: PUB564

Evaluation of Serum Beta-2 Microglobulin (B2M) in Patients with CKD and People Living with HIV (PLHIV) and CKD

Session Information

• Publication Only

Category: CKD (Non-Dialysis)

• 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Torres Rojas, Andrea, Doctorado en Biología Molecular en Medicina, Dpto Biología Molecular y Genómica, CUCS-UDG, Guadalajara, Jalisco, Mexico

Andrea Torres Rojas, PhD

• Álvarez Zavala, Monserrat, Instituto de Investigación en Inmunodeficiencias y VIH (InIVIH), CUCS-UDG., Guadalajara, Jalisco, Mexico

Monserrat Álvarez Zavala, ScD

• Sánchez Reyes, Karina, Instituto de Investigación en Inmunodeficiencias y VIH (InIVIH), CUCS-UDG., Guadalajara, Jalisco, Mexico

Karina Sánchez Reyes, ScD

• Chavez, Jonathan, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Servicio de Nefrología., Guadalajara, Jalisco, Mexico

Jonathan Chavez, PhD

• Martínez Ayala, Pedro, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Unidad de VIH., Guadalajara, Jalisco, Mexico

Pedro Martínez Ayala, MD

• Valle Rodriguez, Adriana, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Unidad de VIH., Guadalajara, Jalisco, Mexico

Adriana Valle Rodriguez, MD

• Andrade Villanueva, Jaime Federico, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Unidad de VIH., Guadalajara, Jalisco, Mexico

Jaime Federico Andrade Villanueva, MD

• Ruiz Herrera, Vida Verónica, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Unidad de VIH., Guadalajara, Jalisco, Mexico

Vida Verónica Ruiz Herrera, MD

• González Hernández, Luz Alicia, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Unidad de VIH., Guadalajara, Jalisco, Mexico

Luz Alicia González Hernández, MD, ScD

Group or Team Name

• Estudio Inmunológico de la Infección por VIH e Inmunodeficiencias Humanas.

Background

Chronic kidney disease (CKD) is one of the main co-morbidities in people living with HIV (PLHIV). In CKD, Cystatin C (CC) and creatinine are the most sensitive markers of renal function. However in HIV, these decrease after the use of antirretroviral therapy (ART), so renal function is underestimated. Beta-2 Microglobulin (B2M) has gained importance as a marker of glomerular and/or tubular damage in CKD. So, we determined and compared serum B2M levels in both groups of patients and correlated with estimated glomerular filtration rate (eGFR) with CKD-EPI equation with creatinine and B2M in order to find a reliable renal function marker for PLHIV.

Methods

Analytical cross-sectional study, in which we included 163 patients with CKD and 102 PLHIV with CKD under ART with undetectable viral loads from the Hospital Civil de Guadalajara. Clinical assessment, laboratory studies and measurement of serum B2M by ELISA were performed.

Results

Comparisons between the groups were significant for B2M, with an increase by stage. There is also a negative correlation between eGFR and B2M in both groups. A ROC curve was performed to define a cut-off point for early renal damage in PLHIV ( >2.37 µg/mL (AUC 0.9622, SE 91%, SP 95%)). In PLHIV, using CKD-EPI B2M equation (133 x B2M^-0.852) eGFR was estimated and compared to CKD-EPI creatinine equation (median: 27.4 vs 52.24 mL/min p 0.0001) and there is a redestribution by stage.Bland & Altman analysis revealed a bias of -15.69±17.99 with a 95% CI (-50.95,+19.58).

Conclusion

CKD stratification in PLHIV has been a challange due to the impact of ART, inflammation and immune reconstitution over CC and creatinine. Since B2M is less variable, it is a promising marker for correct classification and follow-up of CKD in PLHIV.

Funding

• Government Support – Non-U.S.