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Performance of creatinine and cystatin C GFR estimating equations in an HIV-positive population on antiretrovirals.


ABSTRACT: OBJECTIVE:To evaluate the performance of Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine, cystatin C, and creatinine-cystatin C estimating equations in HIV-positive patients. METHODS:We evaluated the performance of the Modification of Diet in Renal Disease (MDRD) Study and CKD-EPI creatinine 2009, CKD-EPI cystatin C 2012, and CKD-EPI creatinine-cystatin C 2012 glomerular filtration rate (GFR) estimating equations compared with GFR measured using plasma clearance of iohexol in 200 HIV-positive patients on stable antiretroviral therapy. Creatinine and cystatin C assays were standardized to certified reference materials. RESULTS:Of the 200 participants, median (IQR) CD4 count was 536 (421) and 61% had an undetectable HIV viral load. Mean (SD) measured GFR (mGFR) was 87 (26) mL/min per 1.73 m. All CKD-EPI equations performed better than the MDRD Study equation. All 3 CKD-EPI equations had similar bias and precision. The cystatin C equation was not more accurate than the creatinine equation. The creatinine-cystatin C equation was significantly more accurate than the cystatin C equation, and there was a trend toward greater accuracy than the creatinine equation. Accuracy was equal or better in most subgroups with the combined equation compared to either alone. CONCLUSIONS:The CKD-EPI cystatin C equation does not seem to be more accurate than the CKD-EPI creatinine equation in patients who are HIV-positive, supporting the use of the CKD-EPI creatinine equation for routine clinical care for use in North American populations with HIV. The use of both filtration markers together as a confirmatory test for decreased estimated GFR based on creatinine in individuals who are HIV-positive requires further study.

SUBMITTER: Inker LA 

PROVIDER: S-EPMC3598619 | biostudies-literature | 2012 Nov

REPOSITORIES: biostudies-literature

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Performance of creatinine and cystatin C GFR estimating equations in an HIV-positive population on antiretrovirals.

Inker Lesley A LA   Wyatt Christina C   Creamer Rebecca R   Hellinger James J   Hotta Matthew M   Leppo Maia M   Levey Andrew S AS   Okparavero Aghogho A   Graham Hiba H   Savage Karen K   Schmid Christopher H CH   Tighiouart Hocine H   Wallach Fran F   Krishnasami Zipporah Z  

Journal of acquired immune deficiency syndromes (1999) 20121101 3


<h4>Objective</h4>To evaluate the performance of Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine, cystatin C, and creatinine-cystatin C estimating equations in HIV-positive patients.<h4>Methods</h4>We evaluated the performance of the Modification of Diet in Renal Disease (MDRD) Study and CKD-EPI creatinine 2009, CKD-EPI cystatin C 2012, and CKD-EPI creatinine-cystatin C 2012 glomerular filtration rate (GFR) estimating equations compared with GFR measured using plasma clear  ...[more]

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