Comparisons Between Validated Estimated Glomerular Filtration Rate Equations and Isotopic Glomerular Filtration Rate in HIV Patients

Overview

Journal AIDS

Specialty Infectious Diseases

Date 2012 Jun 21

PMID 22713478

Citations 18

Authors

Kearkiat Praditpornsilpa

Anchalee Avihingsanon

Tawatchai Chaiwatanarat

Prachya Chaiyahong

Jiratchaya Wongsabut

Sasiwimol Ubolyam

Adhisabandh Chulakadabba

Yingyos Avihingsanon

Kiat Ruxrungtham

Kriang Tunsanga

Somchai Eiam-Ong

Praphan Phanuphak

Affiliations

Soon will be listed here.

Abstract

Objective: Understanding how best to measure renal function in HIV-infected patients is critical because estimated glomerular filtration rate (eGFR) in HIV-infected patients can be affected by ethnicity and body composition. We validated the available eGFR equations and compared them to the plasma Tc-diethylenetriaminepentaacetic acid (Tc-DTPA) clearance in HIV-infected patients.

Design: Test of diagnostic accuracy.

Methods: One hundred and ninety-six HIV-infected patients underwent measuring of Tc-DTPA plasma clearance, five creatinine-based eGFR equations, cystatin-C GFR, and 24-h urine creatinine clearance (CrCl).

Results: Mean (SD) Tc-DTPA GFR was 117.7 ± 29.2 ml/min per 1.73 m. The re-expressed Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), re-expressed MDRD formula with Thai racial correction factor, Thai eGFR equation, Cockcroft-Gault equation, cystatin-C GFR, and 24-h urine CrCl underestimated the reference GFR. The bias estimated by the mean of differences (SD) for the re-expressed MDRD equation, CKD-EPI, re-expressed MDRD formula with Thai racial correction factor, Thai eGFR, Cockcroft-Gault equation, cystatin-C, and 24-h urine CrCl can be expressed as 18.9 ± 27.3, 11.1 ± 25.5, 6.2 ± 28.8, 15.4 ± 27.0, 30.4 ± 28.0, 3.2 + 36.1, and 5.0 ± 12.1 ml/min per 1.73 m, respectively.

Conclusion: The available eGFR equations underestimated GFR in HIV-infected adults. However, the eGFR by cystatin-C GFR was the most precise and accurate. Among creatinine-based eGFR equations, re-expressed MDRD formula with Thai racial correction factor was the most precise and accurate. The racial factor for each ethnicity is important and the existing eGFR equation should be validated before using it in the HIV population.

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