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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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><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Rothenbacher, Dietrich" sort="Rothenbacher, Dietrich" uniqKey="Rothenbacher D" first="Dietrich" last="Rothenbacher">Dietrich Rothenbacher</name><affiliation wicri:level="3"><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><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Ulm</settlement></placeName></affiliation></author><author><name sortKey="Neuhann, Florian" sort="Neuhann, Florian" uniqKey="Neuhann F" first="Florian" last="Neuhann">Florian Neuhann</name><affiliation wicri:level="3"><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><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Heidelberg</settlement></placeName></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 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Limited Settings?</title><author><name sortKey="Glaser, Nicola" sort="Glaser, Nicola" uniqKey="Glaser N" first="Nicola" last="Glaser">Nicola Glaser</name><affiliation wicri:level="3"><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><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Heidelberg</settlement></placeName></affiliation></author><author><name sortKey="Deckert, Andreas" sort="Deckert, Andreas" uniqKey="Deckert A" first="Andreas" last="Deckert">Andreas Deckert</name><affiliation wicri:level="3"><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><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Heidelberg</settlement></placeName></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><wicri:noRegion>Lilongwe</wicri:noRegion></affiliation><affiliation wicri:level="2"><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><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Rothenbacher, Dietrich" sort="Rothenbacher, Dietrich" uniqKey="Rothenbacher D" first="Dietrich" last="Rothenbacher">Dietrich Rothenbacher</name><affiliation wicri:level="3"><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><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Ulm</settlement></placeName></affiliation></author><author><name sortKey="Neuhann, Florian" sort="Neuhann, Florian" uniqKey="Neuhann F" first="Florian" last="Neuhann">Florian Neuhann</name><affiliation wicri:level="3"><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><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Heidelberg</settlement></placeName></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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Cavalier</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shemesh, O" uniqKey="Shemesh O">O Shemesh</name></author><author><name sortKey="Golbetz, H" uniqKey="Golbetz H">H Golbetz</name></author><author><name sortKey="Kriss, Jp" uniqKey="Kriss J">JP Kriss</name></author><author><name sortKey="Myers, Bd" uniqKey="Myers B">BD Myers</name></author></analytic></biblStruct></listBibl></div1></back></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></region><settlement><li>Heidelberg</li><li>Ulm</li></settlement></list><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></region><name sortKey="Deckert, Andreas" sort="Deckert, Andreas" uniqKey="Deckert A" first="Andreas" last="Deckert">Andreas Deckert</name><name sortKey="Neuhann, Florian" sort="Neuhann, Florian" uniqKey="Neuhann F" first="Florian" last="Neuhann">Florian Neuhann</name><name sortKey="Rothenbacher, Dietrich" sort="Rothenbacher, Dietrich" uniqKey="Rothenbacher D" first="Dietrich" last="Rothenbacher">Dietrich Rothenbacher</name></country><country name="Malawi"><noRegion><name sortKey="Phiri, Sam" sort="Phiri, Sam" uniqKey="Phiri S" first="Sam" last="Phiri">Sam Phiri</name></noRegion></country><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></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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