| A comparison of measured and estimated glomerular filtration rate in successfully treated HIV-patients with preserved renal function. | |
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MedLine Citation:
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PMID: 22445475 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Background: Monitoring of renal function becomes increasingly important in the aging population of HIV-1 infected patients. We compared Cockroft & Gault (C&G), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Modification of Diet in Renal Disease (MDRD), Cystatin C- and 24 h urine-based estimated GFR (eGFR) with the gold standard, measured GFR (mGFR) using [125I]-iothalamate. Methods: Substudy within a randomized, multinational trial comparing continuing zidovudine/ lamivudine with switching to tenofovir/ emtricitabine in patients with suppressed HIV-1 infection. Accuracy (defined as the mean difference between eGFR and mGFR) and precision (defined as standard deviation (SD) of the mean difference between eGFR and mGFR) of the eGFRs were calculated using linear regression and Bland & Altman analysis. Results: We included 19 patients, 18 men, 15 Caucasian, mean (SD) age 46.0 y (± 8.9) and BMI 23.9 kg/m2 (± 3.0). Mean (SD) mGFR was 102 ml/min/1.73 m2 (± 19), 4 patients had mild renal dysfunction. All eGFRs tended to underestimate true GFR, with best accuracy for C&G (-1 ml/min/1.73 m2), CKD-EPI (-1 ml/min/1.73 m2), 24 hcreatinine clearance (-2 ml/min/1.73 m2) and MDRD-6 (0 ml/min/1.73 m2), and worst for cystatin C-based (-9 ml/min/1.73 m2) and MDRD-4 estimations (-10 ml/min/1.73 m2). Accuracy worsened at higher mGFR, but was not significantly influenced by age. C&G tended to overestimate at higher BMI. Precision was comparable for all GFR estimations. Conclusions: In this limited number of patients with preserved renal function and suppressed HIV-infection C&G and CKD-EPI appeared to be the best reflection of real GFR and most practical tool for monitoring GFR. |
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Authors:
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Saskia M E Vrouenraets; Christoph A Fux; Ferdinand W N M Wit; Evian Fernandez Garcia; Kees Brinkman; Frans J Hoek; Jan P van Straalen; Hansjakob Furrer; Ray T Krediet; Peter Reiss For The Prepare Study Group |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical nephrology Volume: 77 ISSN: 0301-0430 ISO Abbreviation: Clin. Nephrol. Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-03-26 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0364441 Medline TA: Clin Nephrol Country: Germany |
Other Details:
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Languages: eng Pagination: 311-20 Citation Subset: IM |
Affiliation:
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Center for Poverty-related Communicable Disorders, Center for Infection and Immunity, and Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, the Netherlands, Clinic for Infectious Diseases, University Hospital Bern, Bern, Switzerland, IATEC, Onze Lieve Vrouwe Gasthuis, Department of Clinical Chemistry and Department of Nephrology, Academic Medical Center, Amsterdam, The Netherlands. |
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