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. 2024 Apr 23;25(1):144.
doi: 10.1186/s12882-024-03581-3.

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

Enock Wekiya  1   2 , Godfrey P Mujuzi  3 , Jane Nakiyingi  4 , Juliet Sanya  4 , Moses Matovu  3 , Ocung Guido  3 , Jane Nakaweesi  4 , Charles Karamagi  3 , Joan K Nakayaga  3 , Edrisa I Mutebi  3 , Damalie Nakanjako  3
Affiliations

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

Enock Wekiya et al. BMC Nephrol. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Cockcroft and Gault; Creatinine; Cystatin C based eGFR; Glomerular filtration rate; Likelihood ratio; ROC analysis; Sensitivity; Specificity.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Showing receiver operating characteristics curve analysis of diagnostic accuracy of eGFR Cystatin C based eGFR. The eGFR Creatinine was used as a reference at cut off value 60 mL/min/1.73 m.2
See this image and copyright information in PMC

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