title: Long term reference change value of creatinine in HIV-positive patients with anti-retroviral therapy: A new tool in clinical practice.
abstract: BACKGROUND
  The use of reference change value (RCV) instead of reference interval emerged as an alternative approach for longitudinal interpretation of biological marker. Follow-up of creatinine variation in HIV-positive adults remains a challenge in order to prevent renal complications.
  
  
  OBJECTIVE
  To determine the long term RCV of creatinine in HIV-positive adults receiving anti-retroviral therapy (ART) according to the use of tenofovir or ritonavir.
  
  
  METHODS
  Longitudinal study of 24 months that include 124 HIV-positive patients followed in HIV outpatient unit. Plasma creatinine was measured at 0, 6, 12 and 24 months in order to calculate the RCV.
  
  
  RESULTS
  In the whole group, a 24-month RCV of creatinine was 22.5%. Whatever the ART, the index of individuality was <0.6. Significantly higher RCV of creatinine was observed in patients receiving the association tenofovir and ritonavir (28%) compared to the patients receiving i) tenofovir without ritonavir (21.9%), ii) no tenofovir but ritonavir (22.2%), and iii) no tenofovir and no ritonavir (19.7%).
  
  
  CONCLUSIONS
  The low value of index of individuality pinpointed that RCV should be used to identify critical change in serial creatinine results in HIV-positive adults. RCV of creatinine under ART was around 20% but reached 28% in case of association of tenofovir and ritonavir.
authors.affiliation: Department of Biochemistry, Montpellier University Hospital, Montpellier, France; UMR 204 NUTRIPASS, Universités Montpellier I/II, Montpellier, France.
authors.forename: S
authors.initials: S
authors.lastname: Badiou
authors.affiliation: UMI 233, IRD Inst Res Devt, Université Montpellier I, Montpellier, France.
authors.forename: A
authors.initials: A
authors.lastname: Cournil
authors.affiliation: Department of Biochemistry, Montpellier University Hospital, Montpellier, France.
authors.forename: S
authors.initials: S
authors.lastname: Toubal
authors.affiliation: Department of Biochemistry, Montpellier University Hospital, Montpellier, France.
authors.forename: A S
authors.initials: AS
authors.lastname: Bargnoux
authors.affiliation: Department of Biochemistry, Montpellier University Hospital, Montpellier, France.
authors.forename: A M
authors.initials: AM
authors.lastname: Dupuy
authors.affiliation: Department of Infectious Diseases, Montpellier University Hospital, Montpellier, France.
authors.forename: C
authors.initials: C
authors.lastname: Fernandez
authors.affiliation: UMI 233, IRD Inst Res Devt, Université Montpellier I, Montpellier, France.
authors.forename: H
authors.initials: H
authors.lastname: Peyriere
authors.affiliation: UMI 233, IRD Inst Res Devt, Université Montpellier I, Montpellier, France; Department of Infectious Diseases, Montpellier University Hospital, Montpellier, France.
authors.forename: J
authors.initials: J
authors.lastname: Reynes
authors.affiliation: Department of Biochemistry, Montpellier University Hospital, Montpellier, France; UMR 204 NUTRIPASS, Universités Montpellier I/II, Montpellier, France. Electronic address: jp-crsitol@chu-montpellier.fr.
authors.forename: J P
authors.initials: JP
authors.lastname: Cristol
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects*; D054316:Biomarkers, Pharmacological / Q000097:blood; D003404:Creatinine / Q000097:blood*; D016903:Drug Monitoring; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced / Q000175:diagnosis*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D019438:Ritonavir / Q000009:adverse effects; D000068698:Tenofovir / Q000009:adverse effects
chemical_list: D019380:Anti-HIV Agents; D054316:Biomarkers, Pharmacological; D000068698:Tenofovir; D003404:Creatinine; D019438:Ritonavir
keywords: Creatinine; HIV; Reference change value; Renal; Ritonavir; tenofovir