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Creatine equations comparable to measured GFR for HIV-positive patients

Issue: December 2019

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Juhi Chaudhari

WASHINGTON — Ritonavir-boosted protease inhibitors do not significantly impact creatinine-based GFR estimates compared with measured GFR for HIV-positive patients, according to data presented at ASN Kidney Week.

“It is safe to use these equations in HIV-positive populations without any biased results,” Juhi Chaudhari, MPH, of Tufts Medical Center, said here.

Chaudhari and colleagues studied how the use of ritonavir-boosted protease inhibitors affects creatinine-based GFR estimates in HIV-positive patients who were taking antiretroviral therapy. The study enrolled 200 patients, of which 73% were men, 52% were black and 34% were older than 50 years. Additionally, 61% of the patients studied were virologically suppressed and 44% were taking a ritonavir-boosted protease inhibitor.

Researchers evaluated the performance of the CKD-EPI creatinine (CKD-EPI_Cr) equation, MDRD Study equation and Cockcroft-Gault creatinine clearance compared with the performance of measured GFR.

Chaudhari said the CKD-EPI_Cr equation performed better than the other two equations. Additionally, researchers did not find any clinically or statistically significant differences in the performances of any equation for patients taking and those not taking ritonavir-boosted protease inhibitors.

“People are worried about using creatine equations in other populations, like HIV, diabetes or subpopulations of disease. They are not sure how well the equation performs in these niche populations,” Chaudhari told Healio Nephrology. “But our study shows it is safe to use creatine equations, like the CKD-EPI_Cr. That one did better than the other two creatine equations and the results were comparable to the gold standard. The cell culture studies say maybe the marker they are using for the estimation may be a little bulky in HIV-positive patients but, in actuality in the patients themselves, we saw there were no significant differences,” she said. – by Kristine Houck, MA, ELS

Reference:

Chaudhari J, et al. Abstract TH-PO396. Presented at: ASN Kidney Week; Nov. 7-10, 2019; Washington D.C.

Disclosure: Chaudhari reports the original study was funded by Gilead Sciences and an NIH grant and the current analysis was funded by a NIDDK grant.