纠正抗逆转录病毒治疗对肾小管肌酐分泌影响的估算肾小球滤过率：一种方法适合所有人吗？

Correcting eGFR for the effects of ART on tubular creatinine secretion: does one size fit all?

机构信息

Department of Sexual Health and HIV, King's College Hospital NHS Foundation Trust, London, UK.

Department of Infectious Diseases, King's College London, London, UK.

出版信息

Antivir Ther. 2020;25(5):241-243. doi: 10.3851/IMP3378.

DOI:10.3851/IMP3378

PMID:33459634

Abstract

Several antiretrovirals including dolutegravir, rilpivirine and cobicistat inhibit tubular creatinine secretion, leading to benign increases in serum creatinine and reductions in estimated glomerular filtration rate (eGFR). This commentary discusses the magnitude and pattern of eGFR decline, whether this can be overcome by applying a standardized correction factor (as reported by Brunet et al. in Antiviral Therapy), the value of serial eGFR measures to detect rapid eGFR decline and the potential utility of cystatin C as an alternative biomarker of kidney function.

摘要

几种抗逆转录病毒药物，包括多替拉韦、利匹韦林和考比司他，会抑制肾小管分泌肌酐，导致血清肌酐升高和估计肾小球滤过率（eGFR）降低。这篇评论讨论了 eGFR 下降的幅度和模式，应用标准化校正因子（如 Brunet 等人在《抗病毒治疗》中报告的）是否可以克服这一问题，连续 eGFR 测量值检测快速 eGFR 下降的价值，以及胱抑素 C 作为替代肾功能生物标志物的潜在效用。