This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Background: Monitoring renal function is an important part of clinical care and research. There is little guidance from the literature on how this should be done for HIV-infected patients. Body morphology abnormalities and weight shifts that occur among some HIV-infected patients may have a dramatic effect on the validity of the equations used to estimate GFR. Although measured glomerular filtration rate (GFR) is considered the gold standard, it is cumbersome, expensive, and not readily accessible in clinical settings. Thus, calculated GFR is used in routine clinical care. We have found marked differences in calculated GFR when using different formulas among HIV-infected patients.Purpose: Determine the best formula for calculating GFR among HIV-infected patients with lipoatrophy or lipohypertrophy.Methods: We will compare calculated GFR to GFR measured using a non-isotope iothalamate technique in a well characterized sample of 76 HIV-infected patients with lipoatrophy and lipohypertrophy. Calculated GFR will be performed using Cockroft-Gault (CG) creatinine clearance as an estimate of GFR and the modification of diet in renal disease (MDRD) formula to estimate GFR. Our analyses will focus on the accuracy of calculated GFR measures in comparison with measured GFR including calculations of bias and precision. Conclusions: This pilot study will evaluate the measurement of several estimated GFR techniques to determine their accuracy and precision among two of the groups of HIV-infected patients for whom estimated GFR equations are likely to be most problematic. This will contribute to our understanding of how we should be monitoring HIV-infected patients in clinical settings.
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