The clinical utility of cystatin C based eGFR in assessing renal function among HIV/AIDs patients on ART at Mildmay Uganda

• Published in: BMC nephrology 2024-04, Vol.25 (1), p.144-144, Article 144
• Main Authors: Wekiya, Enock, Mujuzi, Godfrey P, Nakiyingi, Jane, Sanya, Juliet, Matovu, Moses, Guido, Ocung, Nakaweesi, Jane, Karamagi, Charles, Nakayaga, Joan K, Mutebi, Edrisa I, Nakanjako, Damalie
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Acquired Immunodeficiency Syndrome - blood; Acquired Immunodeficiency Syndrome - drug therapy; Adult; AIDS; Antiretroviral therapy; Biomarkers - blood; Care and treatment; Cockcroft and Gault; Complications and side effects; Creatinine; Creatinine - blood; Cross-Sectional Studies; Cystatin C; Cystatin C - blood; Cystatin C based eGFR; Diagnosis; Efficiency; Epidermal growth factor receptors; Female; Glomerular Filtration Rate; Health aspects; HIV; HIV infection; HIV Infections - blood; HIV Infections - complications; HIV Infections - drug therapy; Human immunodeficiency virus; Humans; Immune system; Kidney diseases; Likelihood ratio; Male; Middle Aged; Patients; Renal function; Risk factors; ROC analysis; Sensitivity and Specificity; Uganda
• ISSN: 1471-2369; 1471-2369
• DOI: 10.1186/s12882-024-03581-3

In clinical practice, Measurement of estimated glomerular filtration rates (eGFR) is the gold standard assessing renal function the glomerular filtration rate often estimated from plasma creatinine. Several studies have shown Cystatin C based eGFR (Cys C) to be a better parameter for the diagnosis of impaired renal function. Cystatin C based eGFR has been proposed as a potential renal function marker but its use in HIV&AIDS patients has not been well evaluated. A cross sectional study was carried out on 914 HIV&AIDS patients on antiretroviral therapy (ART) attending Mildmay Uganda for care and treatment between January to March 2015. Serum Cystatin C based eGFR was measured using the particle enhanced immunoturbidimetric assay. Creatinine was analyzed using enzymatic Creatinine PAP method and creatinine clearance was calculated according to C&G. The sensitivity of Cystatin C based eGFR was 15.1% (95% CI = 8.4, 24) with specificity 99.3% (95% CI = 98- 99.7). The positive and negative predictive values were 70.0% (95% CI 45.7-88.1) and 91.2% (95% CI 98.11-92.94) respectively. The positive likelihood ratio was 18.81 and negative likelihood ratio was 0.85. Cystatin C based eGFR had diagnostic accuracy of 90.7 and area under curve was 0.768. Cystatin C based eGFR exhibited a high specificity and a high positive likelihood ratio in diagnosis of kidney disease among HIV&AIDS patients. Cystatin C based eGFR can be used as a confirmatory test.