Estimation of renal function by CKD-EPI versus MDRD in a cohort of HIV-infected patients: a cross-sectional analysis

Estimation of renal function by CKD-EPI versus MDRD in a cohort of HIV-infected patients: a cross-sectional analysis

Author Cristelli, M. P. Autor UNIFESP Google Scholar
Cofan, F. Google Scholar
Rico, N. Google Scholar
Trullas, J. C. Google Scholar
Manzardo, C. Google Scholar
Aguero, F. Google Scholar
Bedini, J. L. Google Scholar
Moreno, A. Google Scholar
Oppenheimer, F. Google Scholar
Miro, J. M. Google Scholar
Abstract Background: Accurately determining renal function is essential for clinical management of HIV patients. Classically, it has been evaluated by estimating glomerular filtration rate (eGFR) with the MDRD-equation, but today there is evidence that the new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation has greater diagnostic accuracy. To date, however, little information exists on patients with HIV-infection. This study aimed to evaluate eGFR by CKD-EPI vs. MDRD equations and to stratify renal function according to KDIGO guidelines. Methods: Cross-sectional, single center study including adult patients with HIV-infection. Results: Four thousand five hundred three patients with HIV-infection (864 women

19%) were examined. Median age was 45 years (IQR 37-52), and median baseline creatinine was 0.93 mg/dL (IQR 0.82-1.05). A similar distribution of absolute measures of eGFR was found using both formulas (p = 0.548). Baseline median eGFR was 95.2 and 90.4 mL/min/ 1.73 m(2) for CKD-EPI and MDRD equations (p < 0.001), respectively. Of the 4503 measurements, 4109 (91.2%) agreed, with a kappa index of 0.803. MDRD classified 7.3% of patients as '' mild reduced GFR '' who were classified as '' normal function '' with CKD-EPI. Using CKD-EPI, it was possible to identify '' normal function '' (>90 mL/min/1.73 m(2)) in 73% patients and '' mild reduced GFR '' (60-89 mL/min/1.73 m(2)) in 24.3% of the patients, formerly classified as >60 mL/min/1.73 m(2) with MDRD. Conclusions: There was good correlation between CKD-EPI and MDRD. Estimating renal function using CKD-EPI equation allowed better staging of renal function and should be considered the method of choice. CKD-EPI identified a significant proportion of patients (24%) with mild reduced GFR (60-89 mL/min/1.73 m(2)).
Keywords HIV-infection
Chronic kidney disease
Glomerular filtration rate estimates
xmlui.dri2xhtml.METS-1.0.item-coverage London
Language English
Sponsor Red de Sida
Instituto de Salud Carlos III, Madrid, Spain
European Regional Development Fund (ERDF)
Grant number Red de Sida: RD12/0017/0001
Instituto de Salud Carlos III, Madrid, Spain: INT15/00168
Date 2017
Published in Bmc Nephrology. London, v. 18, p. -, 2017.
ISSN 1471-2369 (Sherpa/Romeo, impact factor)
Publisher Biomed Central Ltd
Extent -
Origin http://dx.doi.org/10.1186/s12882-017-0470-4
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000397680500002
URI https://repositorio.unifesp.br/handle/11600/55105

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