Comparison of Various Equations for Estimating GFR in Malawi: How to Determine Renal Function in Resource Limited Settings?
Identifieur interne : 001804 ( Main/Exploration ); précédent : 001803; suivant : 001805Comparison 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
Affiliations:
- Allemagne, Malawi, États-Unis
- Bade-Wurtemberg, Caroline du Nord, District de Karlsruhe, District de Tübingen
- Heidelberg, Ulm
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<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>
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</TEI>
<affiliations><list><country><li>Allemagne</li>
<li>Malawi</li>
<li>États-Unis</li>
</country>
<region><li>Bade-Wurtemberg</li>
<li>Caroline du Nord</li>
<li>District de Karlsruhe</li>
<li>District de Tübingen</li>
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<tree><country name="Allemagne"><region name="Bade-Wurtemberg"><name sortKey="Glaser, Nicola" sort="Glaser, Nicola" uniqKey="Glaser N" first="Nicola" last="Glaser">Nicola Glaser</name>
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<name sortKey="Rothenbacher, Dietrich" sort="Rothenbacher, Dietrich" uniqKey="Rothenbacher D" first="Dietrich" last="Rothenbacher">Dietrich Rothenbacher</name>
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<country name="Malawi"><noRegion><name sortKey="Phiri, Sam" sort="Phiri, Sam" uniqKey="Phiri S" first="Sam" last="Phiri">Sam Phiri</name>
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<country name="États-Unis"><region name="Caroline du Nord"><name sortKey="Phiri, Sam" sort="Phiri, Sam" uniqKey="Phiri S" first="Sam" last="Phiri">Sam Phiri</name>
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</record>
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