Comparison of Various Equations for Estimating GFR in Malawi: How to Determine Renal Function in Resource Limited Settings?
Identifieur interne : 000166 ( Pmc/Curation ); précédent : 000165; suivant : 000167Comparison of Various Equations for Estimating GFR in Malawi: How to Determine Renal Function in Resource Limited Settings?
Auteurs : Nicola Glaser [Allemagne] ; Andreas Deckert [Allemagne] ; Sam Phiri [Malawi, États-Unis] ; Dietrich Rothenbacher [Allemagne] ; Florian Neuhann [Allemagne]Source :
- PLoS ONE [ 1932-6203 ] ; 2015.
Abstract
Chronic kidney disease (CKD) is a probably underrated public health problem in Sub-Saharan-Africa, in particular in combination with HIV-infection. Knowledge about the CKD prevalence is scarce and in the available literature different methods to classify CKD are used impeding comparison and general prevalence estimates.
This study assessed different serum-creatinine based equations for glomerular filtration rates (eGFR) and compared them to a cystatin C based equation. The study was conducted in Lilongwe, Malawi enrolling a population of 363 adults of which 32% were HIV-positive.
Comparison of formulae based on Bland-Altman-plots and accuracy revealed best performance for the CKD-EPI equation without the correction factor for black Americans. Analyzing the differences between HIV-positive and –negative individuals CKD-EPI systematically overestimated eGFR in comparison to cystatin C and therefore lead to underestimation of CKD in HIV-positives.
Our findings underline the importance for standardization of eGFR calculation in a Sub-Saharan African setting, to further investigate the differences with regard to HIV status and to develop potential correction factors as established for age and sex.
Url:
DOI: 10.1371/journal.pone.0130453
PubMed: 26083345
PubMed Central: 4470826
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Comparison of Various Equations for Estimating GFR in Malawi: How to Determine Renal Function in Resource Limited Settings?</title><author><name sortKey="Glaser, Nicola" sort="Glaser, Nicola" uniqKey="Glaser N" first="Nicola" last="Glaser">Nicola Glaser</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Institute of Public Health, University of Heidelberg, Heidelberg, Germany</addr-line></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institute of Public Health, University of Heidelberg, Heidelberg</wicri:regionArea></affiliation></author><author><name sortKey="Deckert, Andreas" sort="Deckert, Andreas" uniqKey="Deckert A" first="Andreas" last="Deckert">Andreas Deckert</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Institute of Public Health, University of Heidelberg, Heidelberg, Germany</addr-line></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institute of Public Health, University of Heidelberg, Heidelberg</wicri:regionArea></affiliation></author><author><name sortKey="Phiri, Sam" sort="Phiri, Sam" uniqKey="Phiri S" first="Sam" last="Phiri">Sam Phiri</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>The Lighthouse Trust, Lilongwe, Malawi</addr-line></nlm:aff><country xml:lang="fr">Malawi</country><wicri:regionArea>The Lighthouse Trust, Lilongwe</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, University of North Carolina, Chapel Hill, North Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Rothenbacher, Dietrich" sort="Rothenbacher, Dietrich" uniqKey="Rothenbacher D" first="Dietrich" last="Rothenbacher">Dietrich Rothenbacher</name><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany</addr-line></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institute of Epidemiology and Medical Biometry, Ulm University, Ulm</wicri:regionArea></affiliation></author><author><name sortKey="Neuhann, Florian" sort="Neuhann, Florian" uniqKey="Neuhann F" first="Florian" last="Neuhann">Florian Neuhann</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Institute of Public Health, University of Heidelberg, Heidelberg, Germany</addr-line></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institute of Public Health, University of Heidelberg, Heidelberg</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26083345</idno><idno type="pmc">4470826</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4470826</idno><idno type="RBID">PMC:4470826</idno><idno type="doi">10.1371/journal.pone.0130453</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000166</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000166</idno><idno type="wicri:Area/Pmc/Curation">000166</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000166</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Comparison of Various Equations for Estimating GFR in Malawi: How to Determine Renal Function in Resource Limited Settings?</title><author><name sortKey="Glaser, Nicola" sort="Glaser, Nicola" uniqKey="Glaser N" first="Nicola" last="Glaser">Nicola Glaser</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Institute of Public Health, University of Heidelberg, Heidelberg, Germany</addr-line></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institute of Public Health, University of Heidelberg, Heidelberg</wicri:regionArea></affiliation></author><author><name sortKey="Deckert, Andreas" sort="Deckert, Andreas" uniqKey="Deckert A" first="Andreas" last="Deckert">Andreas Deckert</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Institute of Public Health, University of Heidelberg, Heidelberg, Germany</addr-line></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institute of Public Health, University of Heidelberg, Heidelberg</wicri:regionArea></affiliation></author><author><name sortKey="Phiri, Sam" sort="Phiri, Sam" uniqKey="Phiri S" first="Sam" last="Phiri">Sam Phiri</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>The Lighthouse Trust, Lilongwe, Malawi</addr-line></nlm:aff><country xml:lang="fr">Malawi</country><wicri:regionArea>The Lighthouse Trust, Lilongwe</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, University of North Carolina, Chapel Hill, North Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Rothenbacher, Dietrich" sort="Rothenbacher, Dietrich" uniqKey="Rothenbacher D" first="Dietrich" last="Rothenbacher">Dietrich Rothenbacher</name><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany</addr-line></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institute of Epidemiology and Medical Biometry, Ulm University, Ulm</wicri:regionArea></affiliation></author><author><name sortKey="Neuhann, Florian" sort="Neuhann, Florian" uniqKey="Neuhann F" first="Florian" last="Neuhann">Florian Neuhann</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Institute of Public Health, University of Heidelberg, Heidelberg, Germany</addr-line></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institute of Public Health, University of Heidelberg, Heidelberg</wicri:regionArea></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title><p>Chronic kidney disease (CKD) is a probably underrated public health problem in Sub-Saharan-Africa, in particular in combination with HIV-infection. Knowledge about the CKD prevalence is scarce and in the available literature different methods to classify CKD are used impeding comparison and general prevalence estimates.</p></sec><sec id="sec002"><title>Methods</title><p>This study assessed different serum-creatinine based equations for glomerular filtration rates (eGFR) and compared them to a cystatin C based equation. The study was conducted in Lilongwe, Malawi enrolling a population of 363 adults of which 32% were HIV-positive.</p></sec><sec id="sec003"><title>Results</title><p>Comparison of formulae based on Bland-Altman-plots and accuracy revealed best performance for the CKD-EPI equation without the correction factor for black Americans. Analyzing the differences between HIV-positive and –negative individuals CKD-EPI systematically overestimated eGFR in comparison to cystatin C and therefore lead to underestimation of CKD in HIV-positives.</p></sec><sec id="sec004"><title>Conclusions</title><p>Our findings underline the importance for standardization of eGFR calculation in a Sub-Saharan African setting, to further investigate the differences with regard to HIV status and to develop potential correction factors as established for age and sex.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Zhang, Q" uniqKey="Zhang Q">Q Zhang</name></author><author><name sortKey="Rothenbacher, D" uniqKey="Rothenbacher D">D Rothenbacher</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Barsoum, Rs" uniqKey="Barsoum R">RS Barsoum</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rabkin, M" uniqKey="Rabkin M">M 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<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id><journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosone</journal-id><journal-title-group><journal-title>PLoS ONE</journal-title></journal-title-group><issn pub-type="epub">1932-6203</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, CA USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26083345</article-id><article-id pub-id-type="pmc">4470826</article-id><article-id pub-id-type="doi">10.1371/journal.pone.0130453</article-id><article-id pub-id-type="publisher-id">PONE-D-14-55125</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Comparison of Various Equations for Estimating GFR in Malawi: How to Determine Renal Function in Resource Limited Settings?</article-title><alt-title alt-title-type="running-head">Evaluation of Different eGFR Formulae in a Malawian Cohort</alt-title></title-group><contrib-group><contrib contrib-type="author" equal-contrib="yes"><name><surname>Glaser</surname><given-names>Nicola</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref><xref rid="cor001" ref-type="corresp">*</xref></contrib><contrib contrib-type="author" equal-contrib="yes"><name><surname>Deckert</surname><given-names>Andreas</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref><xref rid="cor001" ref-type="corresp">*</xref></contrib><contrib contrib-type="author"><name><surname>Phiri</surname><given-names>Sam</given-names></name><xref ref-type="aff" rid="aff002"><sup>2</sup></xref><xref ref-type="aff" rid="aff003"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Rothenbacher</surname><given-names>Dietrich</given-names></name><xref ref-type="aff" rid="aff004"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Neuhann</surname><given-names>Florian</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref></contrib></contrib-group><aff id="aff001"><label>1</label><addr-line>Institute of Public Health, University of Heidelberg, Heidelberg, Germany</addr-line></aff><aff id="aff002"><label>2</label><addr-line>The Lighthouse Trust, Lilongwe, Malawi</addr-line></aff><aff id="aff003"><label>3</label><addr-line>Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America</addr-line></aff><aff id="aff004"><label>4</label><addr-line>Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Guerrot</surname><given-names>Dominique</given-names></name><role>Academic Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1"><addr-line>Rouen University Hospital, FRANCE</addr-line></aff><author-notes><fn fn-type="conflict" id="coi001"><p><bold>Competing Interests: </bold>With regards to the honorarium Florian Neuhann receives from Gilead Sciences, the authors state that this does not alter their adherence to PLOS ONE policies on sharing data and materials.</p></fn><fn fn-type="con" id="contrib001"><p>Conceived and designed the experiments: FN NG SP. Performed the experiments: NG. Analyzed the data: NG AD DR FN. Contributed reagents/materials/analysis tools: SP AD DR. Wrote the paper: NG AD FN SP DR.</p></fn><corresp id="cor001">* E-mail: <email>nicola.glaser@posteo.de</email> (NG); <email>a.deckert@uni-heidelberg.de</email> (AD)</corresp></author-notes><pub-date pub-type="epub"><day>17</day><month>6</month><year>2015</year></pub-date><pub-date pub-type="collection"><year>2015</year></pub-date><volume>10</volume><issue>6</issue><elocation-id>e0130453</elocation-id><history><date date-type="received"><day>13</day><month>12</month><year>2014</year></date><date date-type="accepted"><day>20</day><month>5</month><year>2015</year></date></history><permissions><copyright-year>2015</copyright-year><copyright-holder>Glaser et al</copyright-holder><license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited</license-p></license></permissions><self-uri content-type="pdf" xlink:type="simple" xlink:href="pone.0130453.pdf"></self-uri><abstract><sec id="sec001"><title>Background</title><p>Chronic kidney disease (CKD) is a probably underrated public health problem in Sub-Saharan-Africa, in particular in combination with HIV-infection. Knowledge about the CKD prevalence is scarce and in the available literature different methods to classify CKD are used impeding comparison and general prevalence estimates.</p></sec><sec id="sec002"><title>Methods</title><p>This study assessed different serum-creatinine based equations for glomerular filtration rates (eGFR) and compared them to a cystatin C based equation. The study was conducted in Lilongwe, Malawi enrolling a population of 363 adults of which 32% were HIV-positive.</p></sec><sec id="sec003"><title>Results</title><p>Comparison of formulae based on Bland-Altman-plots and accuracy revealed best performance for the CKD-EPI equation without the correction factor for black Americans. Analyzing the differences between HIV-positive and –negative individuals CKD-EPI systematically overestimated eGFR in comparison to cystatin C and therefore lead to underestimation of CKD in HIV-positives.</p></sec><sec id="sec004"><title>Conclusions</title><p>Our findings underline the importance for standardization of eGFR calculation in a Sub-Saharan African setting, to further investigate the differences with regard to HIV status and to develop potential correction factors as established for age and sex.</p></sec></abstract><funding-group><funding-statement>The study was funded through a grant by the HECTOR Stiftung, Mannheim Germany (<ext-link ext-link-type="uri" xlink:href="http://www.hector-stiftung.de/">http://www.hector-stiftung.de/</ext-link>). FN received the funding. Grant number M55. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement></funding-group><counts><fig-count count="8"></fig-count><table-count count="5"></table-count><page-count count="17"></page-count></counts><custom-meta-group><custom-meta id="data-availability"><meta-name>Data Availability</meta-name><meta-value>All relevant data are within the paper and its Supporting Information files.</meta-value></custom-meta></custom-meta-group></article-meta><notes><title>Data Availability</title><p>All relevant data are within the paper and its Supporting Information files.</p></notes></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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