title: The validity of the modification of diet in renal disease formula in HIV-infected patients: a systematic review.
abstract: OBJECTIVE
  Renal dysfunction is highly prevalent in HIV-infected patients and may require dose adjustment of renally excreted antiretroviral drugs. The Modification of Diet in Renal Disease (MDRD)-4 formula is frequently used in daily practice to estimate patients' renal function. The aim of this systematic review was to assess the validity of the MDRD-4 formula in HIV-infected patients.
  
  
  METHODS
  A systematic search in Pubmed and EMBASE was done to identify studies which compared MDRD-4 with measured glomerular filtration rate (mGFR) in HIV-infected patients.
  
  
  RESULTS
  Five studies were included, which provided data from 464 HIV-infected patients with mean mGFR ranging from 87 to 118 ml/min/1.73 m(2). In all studies, results from the MDRD-4 gave an underestimation of the mGFR. Mean bias ((MDRD-4) - mGFR) ranged from -6 to -11 ml/min/1.73 m(2) across studies. The accuracy expressed in terms of P 30 ranged from 64 to 89 %.
  
  
  CONCLUSIONS
  The MDRD-4 formula is as valid in HIV-positive as in HIV-negative patients. Because the available studies comprised mainly HIV-infected patients with mildly impaired to good renal function (GFR ≥ 60 ml/min/1.73 m(2)), more research is needed to validate the MDRD-4 formula in HIV-infected patients with moderate to severe renal impairment.
authors: Hospital Pharmacy 'ZANOB', 's-Hertogenbosch, The Netherlands, w.eppenga@iq.umcn.nl.
authors: Willemijn L
authors: WL
authors: Eppenga
authors: Matthijs
authors: M
authors: van Luin
authors: Clemens
authors: C
authors: Richter
authors: Hieronymus J
authors: HJ
authors: Derijks
authors: Peter A G M
authors: PA
authors: De Smet
authors: Michel
authors: M
authors: Wensing
mesh_terms: D016263:AIDS-Associated Nephropathy / Q000503:physiopathology*; D000367:Age Factors; D003404:Creatinine / Q000097:blood; D005006:Ethnicity; D005919:Glomerular Filtration Rate; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000503:physiopathology*; D055641:Mathematical Concepts; D012737:Sex Factors
chemical_list: D003404:Creatinine