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Assessing kidney function in HIV infection.

Jonathan A Winston1

  • 1Division of Nephrology, Mount Sinai School of Medicine, New York, USA.

The AIDS Reader
|May 30, 2007
PubMed
Summary
This summary is machine-generated.

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Chronic kidney disease (CKD) is often missed. Estimating glomerular filtration rate (GFR) using formulas like Cockcroft-Gault and MDRD aids in early detection, especially in HIV patients, prompting necessary referrals.

Area of Science:

  • Nephrology
  • Public Health
  • Infectious Disease (HIV)

Background:

  • Chronic kidney disease (CKD) frequently goes undetected.
  • The National Institutes of Health (NIH) recommends reporting estimated glomerular filtration rate (GFR) with serum creatinine.
  • CKD affects up to 10% of individuals with HIV, with higher prevalence when proteinuria is present.

Purpose of the Study:

  • To highlight the importance of GFR estimation in CKD detection.
  • To compare the utility of Cockcroft-Gault and MDRD equations for GFR estimation.
  • To emphasize the need for further evaluation in patients with reduced GFR or proteinuria.

Main Methods:

  • Review of current practices in GFR estimation.
  • Discussion of widely used formulas: Cockcroft-Gault and Modification of Diet in Renal Disease (MDRD) equation.

Related Experiment Videos

  • Analysis of GFR estimation's role in clinical laboratories and patient management.

    • Main Results:

    • Both Cockcroft-Gault and MDRD equations provide superior kidney function evaluation compared to serum creatinine alone.
    • The MDRD equation is considered more reliable for GFR between 20-60 mL/min/1.73m².
    • Neither GFR estimation formula is validated in special populations like HIV patients.

    Conclusions:

    • GFR estimation is crucial for identifying unrecognized CKD, particularly in HIV-infected individuals.
    • Patients with proteinuria or decreased GFR require further nephrological assessment.
    • Standardized reporting of GFR estimates by clinical labs is encouraged to improve CKD management.