Gagneux-Brunon A, Botelho-Nevers E, Delanaye P, Lucht F, Frésard A, Cazorla C, Guglielminotti C, Fafin C, Mariat C, Moranne O
Department of infectious and tropical diseases, university hospital of Saint-Étienne, PRES de Lyon, Lyon, France; Groupe immunité muqueuse et agents pathogènes, université Jean-Monnet, université de Lyon, 42270 Saint-Priest-en-Jarez, France.
Department of infectious and tropical diseases, university hospital of Saint-Étienne, PRES de Lyon, Lyon, France; Groupe immunité muqueuse et agents pathogènes, université Jean-Monnet, université de Lyon, 42270 Saint-Priest-en-Jarez, France.
Med Mal Infect. 2017 Jun;47(4):266-270. doi: 10.1016/j.medmal.2017.04.001. Epub 2017 May 9.
To evaluate concordance between glomerular filtration rate (GFR) estimates (Cockcroft and Gault, modification of diet in renal diseases, chronic kidney disease epidemiology study group equations) for drug dosing in HIV-infected patients.
We performed a monocentric study. GFR was measured using the gold standard method (plasma clearance of iohexol) in 230 HIV-infected patients. Concordance rate was evaluated between measured GFR (mGFR) and estimated GFR (eGFR) for different GFR categories (GFR>90 mL/min, GFR<90 mL/min, GFR>70 mL/min, and GFR<70 mL/min). MDRD and CKD-EPI were used with and without indexation to body surface area (BSA).
Mean age was 48±10 years, mean mGFR was 101±26 mL/min. Concordance between mGFR and eGFR estimated with CG, CKD-EPI (indexed and not indexed to BSA), or MDRD equations (not indexed to BSA) was similar (73%, 73%, 74%, and 73% respectively) for a breakpoint value of 90 mL/min for GFR. At this value, the concordance rate between mGFR and MDRD indexed to BSA was significantly lower (65%, P<0.05). Using 70 mL/min of GFR as the breakpoint value, all equations had similar concordance rates with mGFR (with or without indexation to BSA).
CKD-EPI equation has the same concordance with GFR and with CG when used for drug dosing.
评估用于人类免疫缺陷病毒（HIV）感染患者药物剂量计算的肾小球滤过率（GFR）估计值（Cockcroft和Gault公式、肾脏病饮食改良公式、慢性肾脏病流行病学协作组公式）之间的一致性。
我们进行了一项单中心研究。采用金标准方法（碘海醇血浆清除率）测量了230例HIV感染患者的GFR。评估了不同GFR类别（GFR>90 mL/min、GFR<90 mL/min、GFR>70 mL/min和GFR<70 mL/min）下测量的GFR（mGFR）与估计的GFR（eGFR）之间的一致性率。MDRD公式和CKD-EPI公式分别使用和未使用体表面积（BSA）校正。
平均年龄为48±10岁，平均mGFR为101±26 mL/min。对于GFR的断点值90 mL/min，用CG公式、CKD-EPI公式（校正和未校正BSA）或MDRD公式（未校正BSA）估计的mGFR和eGFR之间的一致性相似（分别为73%、73%、74%和73%）。在此值时，校正BSA的MDRD公式与mGFR之间的一致性率显著较低（65%，P<0.05）。以70 mL/min的GFR作为断点值，所有公式与mGFR的一致性率相似（校正或未校正BSA）。
CKD-EPI公式用于药物剂量计算时与GFR及CG公式具有相同的一致性。
