COMPARISON OF MEASURED AND ESTIMATED CREATININE CLEARANCE IN PATIENTSWITH ADVANCED HIV DISEASE

Study Objective. To assess the accuracy of five creatinine clearance e quations in predicting measured creatinine clearance in hospitalized p atients with human immunodeficiency viral (HIV) infection. Design. Pro spective evaluation over a 6-month period. Setting. Erie County Medica l Center, a 550-bed teaching institution. Patients. Forty-seven HIV-po sitive patients (39 men, 8 women) who were admitted for a variety of H IV-related illnesses and judged clinically to have stable renal functi on. Of the 47 original patients, 44 were evaluable based on exclusion criteria. Interventions. Serum creatinine and 24-hour measured creatin ine clearance were performed in each patient. Measurements and Main Re sults. The estimated creatinine clearance from each of the equations ( Cockcroft-Gault, two Jeliffe equations, Mawer et al, and Hull et al) w as compared with the measured creatinine clearance. Statistical analys is of these comparisons was performed and all of the equations were fo und to overestimate the measured creatinine clearance (mean error 34-4 5%). Conclusions. Many HIV-infected patients have a decreased creatini ne clearance despite a serum creatinine concentration within the norma l range. Each of the equations overestimated the measured creatinine c learance.