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A Comparison of Creatinine, Cystatin C, and Creatinine-Cystatin C Based Equations in HIV/AIDS Patients: A
Kweku Amoah Ampiah1, Richard Afari1, Jude Osei-Assibey1
1Department of Medical Laboratory Science University of Cape Coast Cape Coast Central Region Ghana.
Insights
The combined creatinine and cystatin C estimated glomerular filtration rate (eGFR) best predicts kidney dysfunction in HIV/AIDS patients on antiretroviral therapy (ART). Creatinine-based eGFR is better for CKD classification and staging in this population.
Area of Science:
- Nephrology
- Infectious Diseases
- Public Health
Background:
- Chronic kidney disease (CKD) is a growing concern for individuals with HIV/AIDS.
- Kidney dysfunction in this population can progress to end-stage kidney disease (ESKD).
- Early and accurate assessment of kidney function is crucial for managing HIV/AIDS patients on antiretroviral therapy (ART).
Purpose of the Study:
- To evaluate the diagnostic performance of creatinine, cystatin C, and combined eGFR in assessing kidney dysfunction.
- To compare the efficacy of different eGFR formulas in HIV/AIDS patients on ART.
- To identify the optimal method for detecting kidney impairment in this vulnerable group.
Main Methods:
- A cross-sectional study involving 100 HIV/AIDS patients on ART.
- Collection of anthropometric data, blood pressure, and demographic information.
- Measurement of serum creatinine and cystatin C levels, and urine micro-albuminuria testing.
Main Results:
- Serum creatinine levels were within the normal range for most participants.
- The combined (creatinine + cystatin C)-based eGFR showed the highest diagnostic performance (AUC=0.91).
- Creatinine-based eGFR demonstrated better CKD classification and staging capabilities.
Conclusions:
- The combined (creatinine + cystatin C)-based eGFR is the most effective for predicting kidney insufficiency in HIV/AIDS patients on ART.
- Serum cystatin C-based eGFR is valuable for assessing kidney function in patients with eGFR < 60 mL/min/1.73 m².
- Creatinine-based eGFR equations are superior for CKD classification and staging in this cohort.
Background And Aim:
Chronic kidney disease (CKD) is becoming prevalent among people living with HIV/AIDS infection, with kidney dysfunction progressing to end-stage kidney disease (ESKD). We tested the diagnostic performance of creatinine, cystatin c, and the combined (creatinine + cystatin c)-based estimated glomerular filtration rate (eGFR) in assessing kidney dysfunction in HIV/AIDS patients on stable antiretroviral therapy (ART) at the Saltpond District Hospital, Ghana.
Methods:
A cross-sectional study of 100 HIV/AIDS patients on ART at the Saltpond District Hospital was conducted. Anthropometric data (height, waist circumference, and weight), blood pressure, and demographic and socioeconomic characteristics were obtained from all enrolled participants through questionnaires. Venous blood was collected for creatinine and cystatin estimation. Urine was also collected and a spot test for micro-albuminuria was performed.
Results:
Our study revealed a mean serum creatinine level of 82.60 ± 21.69 with serum creatinine within the normal range for both female and male participants. The eGFR-Scr seems to have a better eGFR/CKD classification performance than the eGFR-Scys-c and eGFR combined (Scr + Scys). At similar cut-off values, eGFR-Scr + Scys showed the greatest diagnostic performance in HIV/AIDS patients, with the largest AUC (AUC = 0.91) in the ROC plot with a sensitivity of 100% and specificity of 11%.
Conclusions:
The combined (Scr + Scys) based eGFR equation has the best diagnostic performance in predicting kidney insufficiency/CKD in HIV/AIDS patients on ART. Serum cystatin c-based estimated glomerular filtration (eGFR-Scr) equation is better for assessing kidney function for patients with eGFR< 60 mL/min/1.73 m2, and eGFR-Scr based equations are better in eGFR/CKD classification and staging.
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