HIV pozitif hastalarda erken dönemde nefropatiyi göstermede sistatin C, KIM1 ve NGAl biyolojik göstergelerinin önemi

Objective: While the number of our HIV-infected individuals is increasing day by day, patients who are diagnosed are getting older over time. Renal failure, which starts with renal impairment, leads to health problems such as dialysis program, treatment of anemia, treatment of osteoporosis, and increased risk of cardiovascular disease together with the deterioration of the quality of life of patients. With this study, it is aimed to predict the early period of renal dysfunction, which may be one of the complications of HIV-infected individuals, which is an increasing public health problem. Material and Method: In our study, 88 HIV-infected patients and 81 healthy HIV-noninfected individuals who applied to our infectious diseases outpatient clinic were evaluated prospectively. Cystatin C, KIM1, NGAL were studied in the serum samples taken at the first admission during the period when the study was initiated, while KIM1 and NGAL were studied in urine samples. Age, gender, comorbid diseases, drugs used, first CD4 cell count at the time of inclusion, HIV RNA values, and antiretroviral therapy (ART) names, if any, were recorded in HIV-infected patients included in the study and in healthy volunteers as a control group. Serum creatinine, sodium, potassium, calcium, phosphorus levels, protein and creatinine in spot urine, venous blood gas and complete blood count of these patients were recorded. eGFR value was calculated by the Modification of Diet in Renal Disease (MDRD) method. Results: 114 of the total patients were male (67.5%), 55 of them were female (32.5%). It was observed that the mean values of eGFR, Cystatin C in serum, NGAL in serum, NGAL in urine and KIM1 in serum of the patients in the control group were higher than the rates of the patients in the patient group. Mean KIM1 values in urine of the patients in the patient group were higher in the control group (p <0.05). Serum creatinine, Urine protein and Urine creatinine values were higher in the patient group than the control group (p <0.05). The rates of serum phosphorus, current eGFR, serum cystatin C, NGAL in serum, NGAL in urine and KIM1 in serum of the patients were statistically significant (p <0.05). Conclusion: Cystatin C, KIM1 and NGAL in serum, KIM1 and NGAL in urine were measured and compared in HIV-infected patients and non-infected patients in our study. These biomarkers have failed to predict nephropathy at an early stage in HIV-infected patients. It was thought that this should be evaluated with a good number of patients, multicenter or by looking in serial measurements.