Impact of Lean Mass and Bone Density on Glomerular Filtration Rate Estimation in People Living with HIV/AIDS - Sorbonne Université Access content directly
Journal Articles PLoS ONE Year : 2017

Impact of Lean Mass and Bone Density on Glomerular Filtration Rate Estimation in People Living with HIV/AIDS

Abstract

Context: Chronic kidney disease is a frequent complication in persons living with HIV/AIDS. Although previous studies have suggested that the CKD-EPI formula is appropriate to estimate glomerular filtration rate (GFR) in HIV-positive adults with normal kidney function, the optimal way to estimate GFR in those with Stage 3 chronic kidney disease is not known. Moreover, the impact of muscle mass on creatinine level and GFR estimation is unknown.Aim and methods: Our study aimed to evaluate the accuracy of different diagnostic tests available compared to the gold standard measurement of GFR. A group of 44 HIV-1 patients with an estimated GFR between 60 and 30 ml/min/1.73 m2 were included in a single-center cross-sectional study. Serum creatinine and cystatin C were measured. GFR was estimated using Cockcroft-Gault, MDRD, sMDRD, CKD-EPI, CKD-EPIcyst, and CKD-EPIcyst/creat formulae and was measured using isotopic Chrome51 EDTA clearance. Bone density and muscle mass were measured by DXA scan.Results: Mean age was 62±10 years. Mean BMI was 23±4 kg/m2. Prevalence of diabetes was 30% and of hypertension was 47%. Viral load was <40 copies/ml for 90% of the patients, and mean CD4 count was 446±191 cells/mm3. Mean measured GFR was 63.4±16.5 ml/min/1.73 m2. All formulae under-estimated GFR. The best relative precision and accuracy were provided by the CKP-EPI formula. sMDRD, CKD-EPIcyst, and CKD-EPIcyst/creat performed worse than the CKD-EPI formula. Body composition did not significantly influence accuracy or precision of GFR estimation.Conclusion: In HIV-infected patients in stable immunovirologic conditions with CKD stage 3 and high prevalence of metabolic associated conditions, the CKD-EPI formula performed best, although all formulae under estimate GFR.
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hal-03886719 , version 1 (15-04-2024)

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Corinne Isnard Bagnis, Laurence Pieroni, Rachida Inaoui, Philippe Maksud, Stéphanie Lallauret, et al.. Impact of Lean Mass and Bone Density on Glomerular Filtration Rate Estimation in People Living with HIV/AIDS. PLoS ONE, 2017, 12 (11), pp.e0186410. ⟨10.1371/journal.pone.0186410⟩. ⟨hal-03886719⟩
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