CKD-EPI equation: A suitable Glomerular Filtration Rate estimate for drug dosing in HIV-infected patients

A. Gagneux-Brunon (1, 2) , E. Botelho-Nevers (1, 2) , P. Delanaye (3) , F. Lucht (1, 2) , A. Frésard (1, 2) , C. Cazorla (1) , C. Guglielminotti (1) , C. Fafin (4, 5) , C. Mariat (1, 2) , O. Moranne (4, 6)

1 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
2 GIMAP - Groupe Immunité des Muqueuses et Agents Pathogènes
3 CHU-Liège - Centre Hospitalier Universitaire de Liège
4 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
5 UM - Université de Montpellier
6 AIDMP - Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415

OBJECTIVES:To evaluate concordance between glomerular filtration rate (GFR) estimates (Cockcroft and Gault, modification of diet in renal diseases, chronic kidney disease epidemiology study group equations) for drug dosing in HIV-infected patients.PATIENTS AND METHODS:We performed a monocentric study. GFR was measured using the gold standard method (plasma clearance of iohexol) in 230 HIV-infected patients. Concordance rate was evaluated between measured GFR (mGFR) and estimated GFR (eGFR) for different GFR categories (GFR>90 mL/min, GFR<90 mL/min, GFR>70 mL/min, and GFR<70 mL/min). MDRD and CKD-EPI were used with and without indexation to body surface area (BSA).RESULTS:Mean age was 48±10 years, mean mGFR was 101±26 mL/min. Concordance between mGFR and eGFR estimated with CG, CKD-EPI (indexed and not indexed to BSA), or MDRD equations (not indexed to BSA) was similar (73%, 73%, 74%, and 73% respectively) for a breakpoint value of 90 mL/min for GFR. At this value, the concordance rate between mGFR and MDRD indexed to BSA was significantly lower (65%, P<0.05). Using 70 mL/min of GFR as the breakpoint value, all equations had similar concordance rates with mGFR (with or without indexation to BSA).CONCLUSION:CKD-EPI equation has the same concordance with GFR and with CG when used for drug dosing.

Mots clés: Cockcroft and Gault; Cockcroft et Gault; Débit de filtration glomérulaire; Glomerular filtration rate; HIV infection; Infection par le VIH; CKD-EPI

Domaines: Maladies infectieuses

A. Gagneux-Brunon, E. Botelho-Nevers, P. Delanaye, F. Lucht, A. Frésard, et al.. CKD-EPI equation: A suitable Glomerular Filtration Rate estimate for drug dosing in HIV-infected patients. Médecine et Maladies Infectieuses, 2017, 47 (4), pp.266 - 270. ⟨10.1016/j.medmal.2017.04.001⟩. ⟨hal-01895624⟩