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Cystatin C in addition to creatinine for better assessment of glomerular renal function decline in people with HIV receiving antiretroviral therapy.

Authors :
Mondesert E
Reynes J
Makinson A
Bargnoux AS
Plawecki M
Morquin D
Cristol JP
Badiou S
Source :
AIDS (London, England) [AIDS] 2023 Mar 01; Vol. 37 (3), pp. 447-454. Date of Electronic Publication: 2022 Nov 11.
Publication Year :
2023

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 60 ml/min per 1.73 m2 to evaluate agreement on stage 2 and 3 chronic kidney disease (CKD) classification.<br />Design: eGFRcreat, eGFRcys and resulting CKD staging were determined in 262 consecutive patients with HIV-1 (PWH) with a suppressed viral load (<200 copies/ml) under antiretroviral drugs and having impaired renal function (eGFRcreat between 45 and 80 ml/min per 1.73 m2). 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.<br />Results: Mean eGFRcys was higher than mean eGFRcreat (77.7 ± 0.5 vs. 67.9  ± 7.9 ml/min per 1.73 m2, P < 0.0001). 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%.<br />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 60 ml/min per 1.73 m2 for better identification of renal impairment.<br /> (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Details

Language :
English
ISSN :
1473-5571
Volume :
37
Issue :
3
Database :
MEDLINE
Journal :
AIDS (London, England)
Publication Type :
Academic Journal
Accession number :
36695357
Full Text :
https://doi.org/10.1097/QAD.0000000000003434