Validation of estimated renal function measurements compared with the isotopic glomerular filtration rate in an HIV-infected cohort.
We performed a cross-sectional study to determine the best method for estimating the glomerular filtration rate (GFR) in HIV-infected subjects. Isotopic GFR was correlated with 24-h urine creatinine clearance, cystatin C levels, and 3 creatinine-based equations-the Modification of Diet in Renal Disease (MDRD), Cockcroft-Gault (CG), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)-in 15 patients. Cystatin C showed the strongest correlation with isotopic GFR (r=-0.760, p=0.001). When cystatin C was used as the reference variable for all 106 patients, CKD-EPI proved to be superior to the other equations (r=-0.671, p<0.001). Time with HIV infection, unsuppressed viral load, low CD4 T-cell counts, and use of protease inhibitors are related to an increased risk of renal impairment, leading us to recommend early initiation of antiretroviral therapy accompanied by a regular renal study.
Bonjoch
Anna
A
University Hospital Germans Trias, Barcelona, Spain. abonjoch@flsida.org
Bayés
Beatriz
B
Riba
Joaquim
J
Puig
Jordi
J
Estany
Carla
C
Perez-Alvarez
Núria
N
Clotet
Bonaventura
B
Negredo
Eugènia
E
D003404:Creatinine / Q000652:urine*; D003430:Cross-Sectional Studies; D055316:Cystatin C / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006678:HIV / Q000502:physiology; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology* / Q000652:urine; D006801:Humans; D007668:Kidney / Q000503:physiopathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011237:Predictive Value of Tests; D011866:Radioisotope Renography; D015203:Reproducibility of Results; D013997:Time Factors; D019562:Viral Load
D055316:Cystatin C; D003404:Creatinine