Cystatin C in addition to creatinine for better assessment of glomerular renal function decline in people with HIV receiving antiretroviral therapy.
AIDS
; 37(3): 447-454, 2023 03 01.
Article
en En
| MEDLINE
| ID: mdl-36695357
ABSTRACT
OBJECTIVE:
To compare the estimated glomerular filtration rate (eGFR) using the creatinine equation (eGFRcreat) or the cystatin C equation (eGFRcys) in people with HIV (PWH) under antiretroviral drugs. We specifically included patients with an eGFRcreat around 60âml/min per 1.73âm2 to evaluate agreement on stage 2 and 3 chronic kidney disease (CKD) classification.DESIGN:
eGFRcreat, eGFRcys and resulting CKD staging were determined in 262 consecutive patients with HIV-1 (PWH) with a suppressed viral load (<200âcopies/ml) under antiretroviral drugs and having impaired renal function (eGFRcreat between 45 and 80âml/min per 1.73âm2). Antiretroviral drugs regimens were classified into eight groups cobicistat (COBI)+elvitegravir (EVG), ritonavir (RTV)+protease inhibitor, dolutegravir (DTG), DTG+rilpivirine (RPV), RPV, raltegravir (RAL), bictegravir (BIC), and other antiretroviral drugs.RESULTS:
Mean eGFRcys was higher than mean eGFRcreat (77.7â±â0.5 vs. 67.9ââ±â7.9âml/min per 1.73âm2, Pâ<â0.0001). The differences were significant in five treatment groups with COBI/EVG; DTG; DTG+RPV; RPV; RAL. CKD classification was modified for 51% of patients when using eGFRcys instead of eGFRcreat, with reclassification to less severe stages in 37% and worse stages in 14%.CONCLUSION:
This study highlighted significant differences in eGFR depending on the renal marker used in PWH, having a significant impact on CKD classification. eGFRcys should be an additive tool for patients having eGFRcreat around 60âml/min per 1.73âm2 for better identification of renal impairment.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Infecciones por VIH
/
Insuficiencia Renal Crónica
Límite:
Humans
Idioma:
En
Revista:
AIDS
Asunto de la revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Año:
2023
Tipo del documento:
Article