Related Experiment Video
Updated: Jan 11, 2026
08:50
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
16.7K
Biomarkers influence kidney function estimates more so than race among persons with HIV
Peggy-Ita A Obeng-Nyarkoh1, Amanda B Spence1, Richard Teran1
1Georgetown University, 2115 Wisconsin Avenue NW, Suite 130, Washington, DC, 20007, USA.
AIDS Research and Therapy
|November 19, 2025
Summary
Cystatin C improved chronic kidney disease (CKD) estimates in people with HIV (PWH), shifting more individuals to normal kidney function. This biomarker is crucial for accurately assessing kidney function in PWH, especially with certain HIV medications.
Area of Science:
- Nephrology
- Infectious Diseases
- Biomarkers
Background:
- Chronic kidney disease (CKD) is a significant comorbidity in people with HIV (PWH).
- Accurate estimation of glomerular filtration rate (GFR) is essential for managing CKD in PWH.
- Traditional CKD estimating equations may be influenced by race and certain antiretroviral therapies.
Purpose of the Study:
- To evaluate the impact of cystatin C and different CKD-EPI equations (with/without race) on CKD staging in PWH.
- To determine if race modifies the association between biomarkers and CKD stage.
- To identify factors associated with kidney function in PWH.
Main Methods:
- Cross-sectional study of 306 PWH from 2014-2016.
- Applied CKD-EPI equations using creatinine alone and combined with cystatin C.
- Assessed staging agreement and used multivariable regression and Breslow-Day tests.
Main Results:
- Cystatin C inclusion shifted CKD estimates towards normal kidney function across different CKD-EPI equations.
- The effect of cystatin C on CKD staging was more pronounced than the effect of race.
- Age and tobacco use were significantly associated with kidney function.
Conclusions:
- Cystatin C is a valuable biomarker for refining CKD estimates in PWH.
- It helps to confirm diminished kidney function, especially when creatinine levels may be affected by antiretroviral drugs.
- Race was not found to be a significant effect modifier in this PWH cohort.
Related Concept Videos
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
175
Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area.
175
01:17Factors Affecting Renal Clearance: Renal Impairment
403
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
403
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
170
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
170
01:24Serum Studies: Renal Function Tests
345
Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.
345
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
249
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
249
01:28Kidney Transplant I: Introduction
312
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
312