Comparative Evaluation of Creatinine and Cystatin C Derived Glomerular Filtration Rate Methods in Hiv Patients on...

Antiretroviral drugs are associated with adverse effects including chronic kidney disease. The onset of chronic kidney disease manifests with mild reduction in GFR. Early detection of chronic kidney disease is integral component of clinical medicine with major effect on disease labeling, intervention and drug dosing.

We determined the serum creatinine and cystatin-c levels of 55 HIV patients on one year ART, 55 HIV patients on three years ART and 54 apparently healthy controls using colorimetric and immunoturbidimetric methods respectively. Glomerular filtration rates (GFRs) were calculated from serum creatinine and cystatin-c levels with Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations.

The mean±SD GFR derived from serum creatinine (ml/min/1.73m2) were 110.55±14.34, 106.35±19.25 and 121.63±13.88 for HIV patients on one year, three years ART and healthy controls respectively. GFR derived from cystatin-c (ml/min/1.73m2) were 90.96±13.53, 87.27±14.16 and 108.61±12.07 for HIV patients on one year, three years ART and healthy subjects respectively. GFRcreat was higher when compared with GFRcyst in each group (p=0.01). No significant association was seen between body mass index (BMI) and GFRcyst in patients (p= 0.720) and controls (p=0.760). Binary logistic regression analysis for sensitivity between patients and controls showed odd ratios (0.95 and 1.03) for GFRcreat and (1.04 and 0.99) for GFRcyst in group 1 and 2 respectively.

Rather than creatinine, GFR derived from serum cystatin-c might be an ideal renal function estimate for this population of Nigerians for sensitivity and non dependence on age and BMI.