title: Cystatin C and creatinine in an HIV cohort: the nutrition for healthy living study.
abstract: BACKGROUND
  Human immunodeficiency virus (HIV)-infected persons have an increased risk of chronic kidney disease (CKD). Serum creatinine level may underestimate the prevalence of CKD in subjects with decreased lean body mass or liver disease. Level of serum cystatin C, an alternative kidney function marker, is independent of lean body mass.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  250 HIV-infected subjects on highly active antiretroviral therapy in the Nutrition for Healthy Living (NFHL) cohort; 2,628 National Health and Nutrition Examination Survey (NHANES) 2001-2002 subjects.
  
  
  METHODS
  Comparison of serum creatinine levels in NFHL to those in NHANES subjects; comparison of CKD in NFHL subjects ascertained using serum creatinine versus cystatin C levels.
  
  
  METHODS
  Standardized serum creatinine, serum cystatin C, glomerular filtration rate (GFR) estimated from serum creatinine and cystatin C levels.
  
  
  RESULTS
  Creatinine levels were lower in NFHL than NHANES subjects despite greater rates of hepatitis, diabetes, and drug use (mean difference, -0.18 mg/dL; P < 0.001 adjusted for age, sex, and race). Of NFHL subjects, only 2.4% had a creatinine-based estimated GFR less than 60 mL/min/1.73 m(2), but 15.2% had a cystatin-based estimated GFR less than 60 mL/min/1.73 m(2).
  
  
  CONCLUSIONS
  GFR was estimated rather than measured. Other factors in addition to GFR may affect creatinine and cystatin C levels. Measurements of proteinuria were not available.
  
  
  CONCLUSIONS
  Serum creatinine levels may overestimate GFRs in HIV-infected subjects. Kidney disease prevalence may be greater than previously appreciated.
authors.affiliation: Tufts University School of Medicine, Boston, MA 02111, USA. clara.jones@tufts.edu
authors.forename: Clara Y
authors.initials: CY
authors.lastname: Jones
authors.forename: Camille A
authors.initials: CA
authors.lastname: Jones
authors.forename: Ira B
authors.initials: IB
authors.lastname: Wilson
authors.forename: Tamsin A
authors.initials: TA
authors.lastname: Knox
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Levey
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
authors.forename: Sherwood L
authors.initials: SL
authors.lastname: Gorbach
authors.forename: Frederick
authors.initials: F
authors.lastname: Van Lente
authors.forename: Lesley A
authors.initials: LA
authors.lastname: Stevens
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003404:Creatinine / Q000097:blood*; D003430:Cross-Sectional Studies; D055316:Cystatin C; D015891:Cystatins / Q000097:blood*; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000150:complications*; D006801:Humans; D007674:Kidney Diseases / Q000097:blood* / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D009752:Nutritional Status; D015995:Prevalence; D011446:Prospective Studies
chemical_list: C525030:CST3 protein, human; D055316:Cystatin C; D015891:Cystatins; D003404:Creatinine