Ascher SB, et al. - In individuals with HIV, tenofovir disoproxil fumarate (tenofovir) is correlated with elevated concentrations of biomarkers of kidney damage and dysfunction, so researchers examined the association of these kidney biomarkers with longitudinal kidney function decline. In the Multicenter AIDS Cohort Study and Women’s Interagency HIV Study, they assessed relationships of 14 urinary biomarkers of kidney injury with changes in eGFR among 198 men and women with HIV who started tenofovir between 2009 and 2015. In individuals with HIV, urinary biomarkers of kidney injury measured before and after tenofovir initiation were related to subsequent changes in eGFR. Higher baseline β-2-microglobulin, KIM-1, and clusterin were linked to larger first-year eGFR declines, while higher baseline uromodulin was linked to a smaller eGFR decline, after multivariable adjustment. Larger annual eGFR declines from year 1 to year 3 were linked to first-year increase in urinary cystatin C and higher year 1 IL-18.