Renal Function Assessment in a Cohort of HIV Patients: Comparing Estimated Glomerular Filtration Rate Equations in a Cross-Sectional Study
Henry Ohem Okpa *
Department of Internal Medicine, University of Calabar, Calabar, Nigeria and Renal Unit, Department of Internal Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria.
Elvis Mbu Bisong
Department of Family Medicine, University of Calabar, Calabar, Nigeria and Department of Family Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria.
Patrick Ntui Mbu
Renal Unit, Department of Internal Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria.
Daniel Emmanuel Otokpa
Renal Unit, Department of Internal Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria.
Edadi, Ukam Ekup
Renal Unit, Department of Internal Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria.
*Author to whom correspondence should be addressed.
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.
Keywords: Analysis, equation, glomerular filtration rates, HIV