Criteria for Rapid Progression of Renal Dysfunction in Patients Receiving anti-HIV Drugs in the D:A:D Study

Patient selection: HIV-positive patients on anti-HIV medications

The GFR was estimated from the serum creatinine and was normalized for body surface area was monitored over 4 years, with minimal set initial, then every year after that for 4 years (minimum serum creatinine measurements 5).

The initial eGFR was > 90 mL per min per 1.73 square meters

Several followup schedules were evaluated. The following is definition “A”.

Conditions for rapid progression – all of the following:

(1) average eGFR decline >= 5 mL per min per 1.73 square meters over the 4 year period

(2) the absolute annual decline in eGFR was >= 5 mL per min per 1.73 square meters per year in 2 consecutive years

(3) The eGFR was < 90 mL per min per 1.73 square meters at the end of the 4 years

Performance:

• The sensitivity was 38% and specificity 97%

Limitations:

• The Cockroft-Gault formula was used to calculate the eGFR.