Article révisé par les pairs
Résumé : Objectives: The aim of this study was to determine whether the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)- or Cockcroft-Gault (CG)-based estimated glomerular filtration rates (eGFRs) performs better in the cohort setting for predicting moderate/advanced chronic kidney disease (CKD) or end-stage renal disease (ESRD). Methods: A total of 9521 persons in the EuroSIDA study contributed 133873 eGFRs. Poisson regression was used to model the incidence of moderate and advanced CKD (confirmed eGFR <60 and <30mL/min/1.73m2, respectively) or ESRD (fatal/nonfatal) using CG and CKD-EPI eGFRs. Results: Of 133873 eGFR values, the ratio of CG to CKD-EPI was ≥1.1 in 22092 (16.5%) and the difference between them (CG minus CKD-EPI) was ≥10mL/min/1.73m2 in 20867 (15.6%). Differences between CKD-EPI and CG were much greater when CG was not standardized for body surface area (BSA). A total of 403 persons developed moderate CKD using CG [incidence 8.9/1000 person-years of follow-up (PYFU); 95% confidence interval (CI) 8.0-9.8] and 364 using CKD-EPI (incidence 7.3/1000 PYFU; 95% CI 6.5-8.0). CG-derived eGFRs were equal to CKD-EPI-derived eGFRs at predicting ESRD (n=36) and death (n=565), as measured by the Akaike information criterion. CG-based moderate and advanced CKDs were associated with ESRD [adjusted incidence rate ratio (aIRR) 7.17; 95% CI 2.65-19.36 and aIRR 23.46; 95% CI 8.54-64.48, respectively], as were CKD-EPI-based moderate and advanced CKDs (aIRR 12.41; 95% CI 4.74-32.51 and aIRR 12.44; 95% CI 4.83-32.03, respectively). Conclusions: Differences between eGFRs using CG adjusted for BSA or CKD-EPI were modest. In the absence of a gold standard, the two formulae predicted clinical outcomes with equal precision and can be used to estimate GFR in HIV-positive persons. © 2013 British HIV Association.

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