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Comparison of Various Equations for Estimating GFR in Malawi: How to Determine Renal Function in Resource Limited Settings?

Glaser N, Deckert A, Phiri S, Rothenbacher D, Neuhann F - PLoS ONE (2015)

Bottom Line: Knowledge about the CKD prevalence is scarce and in the available literature different methods to classify CKD are used impeding comparison and general prevalence estimates.The study was conducted in Lilongwe, Malawi enrolling a population of 363 adults of which 32% were HIV-positive.Comparison of formulae based on Bland-Altman-plots and accuracy revealed best performance for the CKD-EPI equation without the correction factor for black Americans.

View Article: PubMed Central - PubMed

Affiliation: Institute of Public Health, University of Heidelberg, Heidelberg, Germany.

ABSTRACT

Background: Chronic kidney disease (CKD) is a probably underrated public health problem in Sub-Saharan-Africa, in particular in combination with HIV-infection. Knowledge about the CKD prevalence is scarce and in the available literature different methods to classify CKD are used impeding comparison and general prevalence estimates.

Methods: This study assessed different serum-creatinine based equations for glomerular filtration rates (eGFR) and compared them to a cystatin C based equation. The study was conducted in Lilongwe, Malawi enrolling a population of 363 adults of which 32% were HIV-positive.

Results: Comparison of formulae based on Bland-Altman-plots and accuracy revealed best performance for the CKD-EPI equation without the correction factor for black Americans. Analyzing the differences between HIV-positive and -negative individuals CKD-EPI systematically overestimated eGFR in comparison to cystatin C and therefore lead to underestimation of CKD in HIV-positives.

Conclusions: Our findings underline the importance for standardization of eGFR calculation in a Sub-Saharan African setting, to further investigate the differences with regard to HIV status and to develop potential correction factors as established for age and sex.

No MeSH data available.


Related in: MedlinePlus

Cystatin C (van Deventer) vs. MDRD-4 (without factor for black Americans).
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pone.0130453.g002: Cystatin C (van Deventer) vs. MDRD-4 (without factor for black Americans).


Comparison of Various Equations for Estimating GFR in Malawi: How to Determine Renal Function in Resource Limited Settings?

Glaser N, Deckert A, Phiri S, Rothenbacher D, Neuhann F - PLoS ONE (2015)

Cystatin C (van Deventer) vs. MDRD-4 (without factor for black Americans).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4470826&req=5

pone.0130453.g002: Cystatin C (van Deventer) vs. MDRD-4 (without factor for black Americans).
Bottom Line: Knowledge about the CKD prevalence is scarce and in the available literature different methods to classify CKD are used impeding comparison and general prevalence estimates.The study was conducted in Lilongwe, Malawi enrolling a population of 363 adults of which 32% were HIV-positive.Comparison of formulae based on Bland-Altman-plots and accuracy revealed best performance for the CKD-EPI equation without the correction factor for black Americans.

View Article: PubMed Central - PubMed

Affiliation: Institute of Public Health, University of Heidelberg, Heidelberg, Germany.

ABSTRACT

Background: Chronic kidney disease (CKD) is a probably underrated public health problem in Sub-Saharan-Africa, in particular in combination with HIV-infection. Knowledge about the CKD prevalence is scarce and in the available literature different methods to classify CKD are used impeding comparison and general prevalence estimates.

Methods: This study assessed different serum-creatinine based equations for glomerular filtration rates (eGFR) and compared them to a cystatin C based equation. The study was conducted in Lilongwe, Malawi enrolling a population of 363 adults of which 32% were HIV-positive.

Results: Comparison of formulae based on Bland-Altman-plots and accuracy revealed best performance for the CKD-EPI equation without the correction factor for black Americans. Analyzing the differences between HIV-positive and -negative individuals CKD-EPI systematically overestimated eGFR in comparison to cystatin C and therefore lead to underestimation of CKD in HIV-positives.

Conclusions: Our findings underline the importance for standardization of eGFR calculation in a Sub-Saharan African setting, to further investigate the differences with regard to HIV status and to develop potential correction factors as established for age and sex.

No MeSH data available.


Related in: MedlinePlus