Renal Function Assessment in a Cohort of HIV Patients: Comparing Estimated Glomerular Filtration Rate Equations in a Cross-Sectional Study

Abstract

Introduction: The glomerular filtration formulae are important in staging and determining renal function in HIV patients, and in the general population at large. Aim: The main objective of this study is to evaluate the performance of Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and the Modification of Renal Diet (MDRD) equation in determining renal function in HIV-infected patients. Methods: A cross-sectional study was conducted among 118 adult HIV patients on antiretroviral therapy (ART) attending clinic at the University of Calabar Teaching Hospital. Participants were recruited in a consecutive manner and data were collected using standard structure questionnaire, including clinical and laboratory investigations. The CKD-EPI and MDRD equations were used to calculate estimated glomerular filtration rate (eGFR) and evaluate renal function according to GFR staging. Data were analyzed using descriptive statistics, Chi-square test, ANOVA and P < .05 was accepted to be significant. Results: One hundred and eighteen HIV-infected patients were studied and 82(60.5%) were females. The median age was 39.0 years (IQR 18.0 – 73.0), while the median eGFR were 84.0mL/min (IQR 26.0 - 192.0) and 82.0mL/min (IQR 22.0 – 124.0) using the CKD-EPI and MDRD equation respectively. The mean eGFR was significantly lower based on MDRD equation (81.13±22.15, P = .001) as compared to CKD-EPI equation (85.29±26.47, P = .06). Also, 22(18.6%) of the participants had CKD (eGFR < 60mL/min) based on MDRD as compared to 17(14.4%) using CKD-EPI equation, and this was statistically significant. This may possibly imply that MDRD may overestimate the severity of renal impairment in HIV patients. Conclusion: There was a fairly good comparison between CKD-EPI and MDRD in estimating renal function in HIV positive cohort. CKD-EPI equation showed a better staging of renal function without overestimating advanced renal impairment. Although no gold standard method was employed for comparison.