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Abstract
Albuminuria is a key biomarker for cardiovascular disease and chronic kidney disease. Our study aimed to describe the prevalence of albuminuria amongst people who inject drugs in London and to test any potential associations with demographic characteristics, past diagnoses, and drug preparation and administration practices. We carried out a cross-sectional survey amongst people who use drugs in London. The main outcome measure was any albuminuria including both microalbuminuria and macroalbuminuria. Three-hundred and sixteen samples were tested by local laboratory services. Our study initially employed point-of-care testing methods but this resulted in a high number of false positives. Our findings suggest the prevalence of albuminuria amongst PWID is twice that of the general population at 19% (95%CI 15.3–24.0%). Risk factors associated with albuminuria were HIV (aOR 4.11 [95% CI 1.37–12.38]); followed by overuse of acidifier for dissolving brown heroin prior to injection (aOR 2.10 [95% CI 1.04–4.22]). Albuminuria is high amongst people who inject drugs compared to the general population suggesting the presence of increased cardiovascular and renal pathologies. This is the first study to demonstrate an association with acidifier overuse. Dehydration may be common amongst this population and may affect the diagnostic accuracy of point-of-care testing for albuminuria.
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1 Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, UK (GRID:grid.8991.9) (ISNI:0000 0004 0425 469X); Humanitarian Public Health Technical Unit, Save the Children UK, London, UK (GRID:grid.8991.9)
2 Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, UK (GRID:grid.8991.9) (ISNI:0000 0004 0425 469X)
3 Department of Non-communicable Disease Epidemiology, Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK (GRID:grid.8991.9) (ISNI:0000 0004 0425 469X)
4 UCL Collaborative Centre for Inclusion Health, Institute of Epidemiology and Health Care University College London, London, UK (GRID:grid.83440.3b) (ISNI:0000000121901201)
5 Department of Social Genetic & Developmental Psychiatry, Institute of Psychiatry, King’s College London, London, UK (GRID:grid.13097.3c) (ISNI:0000 0001 2322 6764)
6 Department of Pharmacy and Pharmacology, University of Bath, Bath, UK (GRID:grid.7340.0) (ISNI:0000 0001 2162 1699)
7 Public Health Institute, Liverpool John Moores University, Liverpool, UK (GRID:grid.4425.7) (ISNI:0000 0004 0368 0654)
8 University of California, San Francisco, Department of Family and Community Medicine, San Francisco, United States (GRID:grid.266102.1) (ISNI:0000 0001 2297 6811)
9 Camden & Islington NHS Foundation Trust, London, UK (GRID:grid.450564.6)
10 National Amyloidosis Centre, Centre for Amyloidosis & Acute Phase Proteins, Division of Medicine, University College London, London, UK (GRID:grid.83440.3b) (ISNI:0000000121901201)
11 UCL Collaborative Centre for Inclusion Health, Institute of Epidemiology and Health Care University College London, London, UK (GRID:grid.83440.3b) (ISNI:0000000121901201); University College Hospitals NHS Foundation Trust, London, UK (GRID:grid.439749.4) (ISNI:0000 0004 0612 2754)