Limits...
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, Reiss P, Furrer H, D'Arminio Monforte A, Gatell J, de Wit S, Beniowski M, Lundgren JD, Kirk O, EuroSIDA in EuroCOO - HIV Med. (2013)

Bottom Line: 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).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.

View Article: PubMed Central - PubMed

Affiliation: Department of Infection and Population Health, University College London, London, UK.

Show MeSH

Related in: MedlinePlus

Moderate and advanced chronic kidney disease (CKD) as predictors of fatal and nonfatal end-stage renal disease (ESRD) and mortality. Moderate (Mod.) CKD [confirmed (> 3 months apart) estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2] and advanced (Adv.) CKD (confirmed eGFR < 30 mL/min/1.73 m2) are included as time-updated variables. *Multivariate models adjusted for gender, race, ethnic origin, region, CD4 count nadir and baseline date as fixed baseline covariates and hepatitis B, hepatitis C, prior AIDS diagnosis, prior non-AIDS-related event (pancreatitis, malignancy and end-stage liver disease for ESRD (and additionally ESRD for mortality), cardiovascular event, diabetes, hypertension, smoking status, anaemia, starting combination antiretroviral therapy, CD4 count, viral load and age as time-updated variables. BSA, body surface area; CG, Cockcroft−Gault; CI, confidence interval; CKD-EPI, Chronic Kidney Disease Epidemiology Collaboration.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4228765&req=5

fig02: Moderate and advanced chronic kidney disease (CKD) as predictors of fatal and nonfatal end-stage renal disease (ESRD) and mortality. Moderate (Mod.) CKD [confirmed (> 3 months apart) estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2] and advanced (Adv.) CKD (confirmed eGFR < 30 mL/min/1.73 m2) are included as time-updated variables. *Multivariate models adjusted for gender, race, ethnic origin, region, CD4 count nadir and baseline date as fixed baseline covariates and hepatitis B, hepatitis C, prior AIDS diagnosis, prior non-AIDS-related event (pancreatitis, malignancy and end-stage liver disease for ESRD (and additionally ESRD for mortality), cardiovascular event, diabetes, hypertension, smoking status, anaemia, starting combination antiretroviral therapy, CD4 count, viral load and age as time-updated variables. BSA, body surface area; CG, Cockcroft−Gault; CI, confidence interval; CKD-EPI, Chronic Kidney Disease Epidemiology Collaboration.

Mentions: There were 36 persons who developed ESRD or who died from renal disease (incidence rate 0.7/1000 PYFU; 95% CI 0.5–0.9) and 565 deaths (incidence 10.8/1000 PYFU; 95% CI 9.9–11.7) during prospective follow-up. CG-derived eGFRs were equal to CKD-EPI-derived eGFRs at predicting both ESRD and death, as measured by a lower Akaike information criterion and log-likelihood, summarized in Figure 2. After adjustment, CG-derived 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-derived moderate and advanced CKDs (aIRR 12.41; 95% CI 4.74–32.51 and aIRR 12.44; 95% CI 4.83–32.03, respectively). CG-derived moderate CKD but not advanced CKD was associated with all-cause mortality (aIRR 1.45; 95% CI 1.11–1.90 and aIRR 1.52; 95% CI 0.87–2.67, respectively), while CKD-EPI-derived moderate CKD was not significantly associated with all-cause mortality, but advanced CKD was (aIRR 1.12; 95% CI 0.84–1.50 and aIRR 2.08; 95% CI 1.22–3.57, respectively).


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, Reiss P, Furrer H, D'Arminio Monforte A, Gatell J, de Wit S, Beniowski M, Lundgren JD, Kirk O, EuroSIDA in EuroCOO - HIV Med. (2013)

Moderate and advanced chronic kidney disease (CKD) as predictors of fatal and nonfatal end-stage renal disease (ESRD) and mortality. Moderate (Mod.) CKD [confirmed (> 3 months apart) estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2] and advanced (Adv.) CKD (confirmed eGFR < 30 mL/min/1.73 m2) are included as time-updated variables. *Multivariate models adjusted for gender, race, ethnic origin, region, CD4 count nadir and baseline date as fixed baseline covariates and hepatitis B, hepatitis C, prior AIDS diagnosis, prior non-AIDS-related event (pancreatitis, malignancy and end-stage liver disease for ESRD (and additionally ESRD for mortality), cardiovascular event, diabetes, hypertension, smoking status, anaemia, starting combination antiretroviral therapy, CD4 count, viral load and age as time-updated variables. BSA, body surface area; CG, Cockcroft−Gault; CI, confidence interval; CKD-EPI, Chronic Kidney Disease Epidemiology Collaboration.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4228765&req=5

fig02: Moderate and advanced chronic kidney disease (CKD) as predictors of fatal and nonfatal end-stage renal disease (ESRD) and mortality. Moderate (Mod.) CKD [confirmed (> 3 months apart) estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2] and advanced (Adv.) CKD (confirmed eGFR < 30 mL/min/1.73 m2) are included as time-updated variables. *Multivariate models adjusted for gender, race, ethnic origin, region, CD4 count nadir and baseline date as fixed baseline covariates and hepatitis B, hepatitis C, prior AIDS diagnosis, prior non-AIDS-related event (pancreatitis, malignancy and end-stage liver disease for ESRD (and additionally ESRD for mortality), cardiovascular event, diabetes, hypertension, smoking status, anaemia, starting combination antiretroviral therapy, CD4 count, viral load and age as time-updated variables. BSA, body surface area; CG, Cockcroft−Gault; CI, confidence interval; CKD-EPI, Chronic Kidney Disease Epidemiology Collaboration.
Mentions: There were 36 persons who developed ESRD or who died from renal disease (incidence rate 0.7/1000 PYFU; 95% CI 0.5–0.9) and 565 deaths (incidence 10.8/1000 PYFU; 95% CI 9.9–11.7) during prospective follow-up. CG-derived eGFRs were equal to CKD-EPI-derived eGFRs at predicting both ESRD and death, as measured by a lower Akaike information criterion and log-likelihood, summarized in Figure 2. After adjustment, CG-derived 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-derived moderate and advanced CKDs (aIRR 12.41; 95% CI 4.74–32.51 and aIRR 12.44; 95% CI 4.83–32.03, respectively). CG-derived moderate CKD but not advanced CKD was associated with all-cause mortality (aIRR 1.45; 95% CI 1.11–1.90 and aIRR 1.52; 95% CI 0.87–2.67, respectively), while CKD-EPI-derived moderate CKD was not significantly associated with all-cause mortality, but advanced CKD was (aIRR 1.12; 95% CI 0.84–1.50 and aIRR 2.08; 95% CI 1.22–3.57, respectively).

Bottom Line: 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).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.

View Article: PubMed Central - PubMed

Affiliation: Department of Infection and Population Health, University College London, London, UK.

Show MeSH
Related in: MedlinePlus