Chronic Kidney Disease Risk Score of Scherzer et al in an HIV-Positive Male Being Treated with Tenofovir

Description

Scherzer et al developed a score for identifying chronic kidney disease in an HIV-positive patient treated with tenofovir. The authors are from the University of California at San Francisco, San Francisco VA Medical Center, San Francisco General Hospital and the Johns Hopkins University.

Patient selection: HIV-positive male veteran being treated with tenofovir disoproxil fumarate (TDF), >= 19 years of age and without chronic kidney disease (CKD) at entry

Outcome: chronic kidney disease with estimated GFR < 60 mL per min per 1.73 square meter

Parameters:

(1) age in years

(2) serum glucose in mg/dL (presumably fasting)

(3) systolic blood pressure in mm Hg

(4) hypertension

(5) serum triglycerides in mg/dL

(6) proteinuria (urine dipstick protein > 30 mg/dL)

(7) CD4-positive lymphocytes per microliter

Parameter	Finding	Points
age in years	19 to 39 years	0
	40 to 49 years	2
	50 to 59 years	4
	>= 60 years	6
serum glucose	<= 140 mg/dL	0
	> 140 mg/dL	2
systolic blood pressure	<= 140 mm Hg	0
	> 140 mm Hg	1
hypertension	no	0
	yes	2
serum triglycerides	<= 200 mg/dL	0
	> 200 mg/dL	1
proteinuria	no	0
	yes	2
CD4-positive cells	>= 200 per µL	0
	< 200 per µL	1

total score =

= SUM(points for all 7 parameters)

Interpretation:

• minimum score: 0

• maximum score: 15

• The risk of CKD increases with score and a history of therapy with tenofovir.

Total Score	5-Year Rate of CKD If Ever Treated with Tenofovir (TDF)	5-Year Rate of CKD If Never Treated with Tenofovir (TDF)
0	1.1%	0.5%
1	1.9	0.4
2	3.3	1.3
3	4.0	1.8
4	6.0	2.5
5	7.8	3.7
6	9.9	4.6
7	11	7.9
8	17.7	10
>= 9	19.4	14.8

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Chronic Kidney Disease Risk Score of Scherzer et al in an HIV-Positive Male Being Treated with Tenofovir

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