Ampiah Kweku Amoah, Afari Richard, Osei-Assibey Jude, Asamoah Ramseyer, Acheampong Amos, Dzata Lawrence, Kyei-Mensah Joseph, Ahenkorah-Fonjo Linda, Sakyi Samuel A, Abakah-Yawson Albert, Kotam Gabriel Pezahso, Ephraim Richard K D
Department of Medical Laboratory Science University of Cape Coast Cape Coast Central Region Ghana.
Department of Clinical Microbiology, School of Medical Sciences University of Cape Coast Cape Coast Central Region Ghana.
Health Sci Rep. 2024 Dec 12;7(12):e70263. doi: 10.1002/hsr2.70263. eCollection 2024 Dec.
Chronic kidney disease (CKD) is becoming prevalent among people living with HIV/AIDS infection, with kidney dysfunction progressing to end-stage kidney disease (ESKD). We tested the diagnostic performance of creatinine, cystatin c, and the combined (creatinine + cystatin c)-based estimated glomerular filtration rate (eGFR) in assessing kidney dysfunction in HIV/AIDS patients on stable antiretroviral therapy (ART) at the Saltpond District Hospital, Ghana.
A cross-sectional study of 100 HIV/AIDS patients on ART at the Saltpond District Hospital was conducted. Anthropometric data (height, waist circumference, and weight), blood pressure, and demographic and socioeconomic characteristics were obtained from all enrolled participants through questionnaires. Venous blood was collected for creatinine and cystatin estimation. Urine was also collected and a spot test for micro-albuminuria was performed.
Our study revealed a mean serum creatinine level of 82.60 ± 21.69 with serum creatinine within the normal range for both female and male participants. The eGFR-Scr seems to have a better eGFR/CKD classification performance than the eGFR-Scys-c and eGFR combined (Scr + Scys). At similar cut-off values, eGFR-Scr + Scys showed the greatest diagnostic performance in HIV/AIDS patients, with the largest AUC (AUC = 0.91) in the ROC plot with a sensitivity of 100% and specificity of 11%.
The combined (Scr + Scys) based eGFR equation has the best diagnostic performance in predicting kidney insufficiency/CKD in HIV/AIDS patients on ART. Serum cystatin c-based estimated glomerular filtration (eGFR-Scr) equation is better for assessing kidney function for patients with eGFR< 60 mL/min/1.73 m, and eGFR-Scr based equations are better in eGFR/CKD classification and staging.
慢性肾脏病（CKD）在感染人类免疫缺陷病毒/获得性免疫综合征（HIV/AIDS）的人群中日益普遍，肾功能障碍会发展为终末期肾病（ESKD）。我们在加纳盐池地区医院，对接受稳定抗逆转录病毒治疗（ART）的HIV/AIDS患者，测试了基于肌酐、胱抑素C以及联合使用（肌酐+胱抑素C）的估计肾小球滤过率（eGFR）在评估肾功能障碍方面的诊断性能。
在盐池地区医院对100例接受ART的HIV/AIDS患者进行了一项横断面研究。通过问卷调查从所有入组参与者那里获取人体测量数据（身高、腰围和体重）、血压以及人口统计学和社会经济特征。采集静脉血用于肌酐和胱抑素的测定。同时也收集尿液并进行微量白蛋白尿的即时检测。
我们的研究显示，血清肌酐平均水平为82.60±21.69，女性和男性参与者的血清肌酐均在正常范围内。与基于胱抑素C的eGFR（eGFR-Scys-c）和联合使用的eGFR（Scr+Scys）相比，基于血清肌酐的eGFR（eGFR-Scr）似乎具有更好的eGFR/CKD分类性能。在相似的临界值下，eGFR-Scr+Scys在HIV/AIDS患者中显示出最大的诊断性能，在ROC曲线中AUC最大（AUC=0.91），敏感性为100%，特异性为11%。
基于联合使用（Scr+Scys）的eGFR方程在预测接受ART的HIV/AIDS患者的肾功能不全/CKD方面具有最佳诊断性能。基于血清胱抑素C的估计肾小球滤过率（eGFR-Scr）方程对于评估eGFR<60 mL/min/1.73 m²的患者的肾功能更好，并且基于eGFR-Scr的方程在eGFR/CKD分类和分期方面表现更好。
