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A comparison of estimated glomerular filtration rates using cockcroft-gault and the chronic kidney disease epidemiology collaboration estimating equations in HIV infection

Mocroft, A; Ryom, L; Lundgren, J; Kirk, O; Reiss, P; Furrer, H; D'Arminio Monforte, A; ... Beniowski, M; + view all (2014) A comparison of estimated glomerular filtration rates using cockcroft-gault and the chronic kidney disease epidemiology collaboration estimating equations in HIV infection. HIV Medicine , 15 (3) 144 - 152. 10.1111/hiv.12095. Green open access

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Abstract

Objectives: The aim of this study was to determine whether the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)- or Cockcroft-Gault (CG)-based estimated glomerular filtration rates (eGFRs) performs better in the cohort setting for predicting moderate/advanced chronic kidney disease (CKD) or end-stage renal disease (ESRD). Methods: A total of 9521 persons in the EuroSIDA study contributed 133873 eGFRs. Poisson regression was used to model the incidence of moderate and advanced CKD (confirmed eGFR <60 and <30mL/min/1.73m, respectively) or ESRD (fatal/nonfatal) using CG and CKD-EPI eGFRs. Results: Of 133873 eGFR values, the ratio of CG to CKD-EPI was ≥1.1 in 22092 (16.5%) and the difference between them (CG minus CKD-EPI) was ≥10mL/min/1.73m in 20867 (15.6%). Differences between CKD-EPI and CG were much greater when CG was not standardized for body surface area (BSA). A total of 403 persons developed moderate CKD using CG [incidence 8.9/1000 person-years of follow-up (PYFU); 95% confidence interval (CI) 8.0-9.8] and 364 using CKD-EPI (incidence 7.3/1000 PYFU; 95% CI 6.5-8.0). CG-derived eGFRs were equal to CKD-EPI-derived eGFRs at predicting ESRD (n=36) and death (n=565), as measured by the Akaike information criterion. CG-based moderate and advanced CKDs were associated with ESRD [adjusted incidence rate ratio (aIRR) 7.17; 95% CI 2.65-19.36 and aIRR 23.46; 95% CI 8.54-64.48, respectively], as were CKD-EPI-based moderate and advanced CKDs (aIRR 12.41; 95% CI 4.74-32.51 and aIRR 12.44; 95% CI 4.83-32.03, respectively). Conclusions: Differences between eGFRs using CG adjusted for BSA or CKD-EPI were modest. In the absence of a gold standard, the two formulae predicted clinical outcomes with equal precision and can be used to estimate GFR in HIV-positive persons. © 2013 British HIV Association.

Type: Article
Title: A comparison of estimated glomerular filtration rates using cockcroft-gault and the chronic kidney disease epidemiology collaboration estimating equations in HIV infection
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/hiv.12095
Publisher version: http://dx.doi.org/10.1111/hiv.12095
Additional information: © 2013 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Keywords: chronic kidney disease; end stage renal disease; eGFR; renal function;
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/1422121
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