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01.02.2014 | Review

The validity of the modification of diet in renal disease formula in HIV-infected patients: a systematic review

verfasst von: Willemijn L. Eppenga, Matthijs van Luin, Clemens Richter, Hieronymus J. Derijks, Peter A. G. M. De Smet, Michel Wensing

Erschienen in: Journal of Nephrology | Ausgabe 1/2014

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Abstract

Rationale, aims and objectives

Renal dysfunction is highly prevalent in HIV-infected patients and may require dose adjustment of renally excreted antiretroviral drugs. The Modification of Diet in Renal Disease (MDRD)-4 formula is frequently used in daily practice to estimate patients’ renal function. The aim of this systematic review was to assess the validity of the MDRD-4 formula in HIV-infected patients.

Method

A systematic search in Pubmed and EMBASE was done to identify studies which compared MDRD-4 with measured glomerular filtration rate (mGFR) in HIV-infected patients.

Results

Five studies were included, which provided data from 464 HIV-infected patients with mean mGFR ranging from 87 to 118 ml/min/1.73 m². In all studies, results from the MDRD-4 gave an underestimation of the mGFR. Mean bias ((MDRD-4) − mGFR) ranged from −6 to −11 ml/min/1.73 m² across studies. The accuracy expressed in terms of P ₃₀ ranged from 64 to 89 %.

Conclusions

The MDRD-4 formula is as valid in HIV-positive as in HIV-negative patients. Because the available studies comprised mainly HIV-infected patients with mildly impaired to good renal function (GFR ≥ 60 ml/min/1.73 m²), more research is needed to validate the MDRD-4 formula in HIV-infected patients with moderate to severe renal impairment.

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Titel: The validity of the modification of diet in renal disease formula in HIV-infected patients: a systematic review
verfasst von: Willemijn L. Eppenga
Matthijs van Luin
Clemens Richter
Hieronymus J. Derijks
Peter A. G. M. De Smet
Michel Wensing
Publikationsdatum: 01.02.2014
Verlag: Springer International Publishing
Erschienen in: Journal of Nephrology / Ausgabe 1/2014
Print ISSN: 1121-8428
Elektronische ISSN: 1724-6059
DOI: https://doi.org/10.1007/s40620-013-0012-5

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