Regarding the paper ‘Changes in estimated glomerular filtration rate over time in South African HIV-1-infected patients receiving tenofovir: a retrospective cohort study’ by Renee De Waal, Karen Cohen, Matthew P Fox, Kathryn Stinson, Gary Maartens, Andrew Boulle, Ehimario U Igumbor, Mary-Ann Davies.
Published in Journal of the International AIDS Society, Citation: De Waal et al. Journal of the International AIDS Soceity, 20:21317. http://www.jiasociety.org/index.php/jias/article/view/21317 |https://doi.org/10.7448/IAS.20.01/21317
There was an error in one of the eGFR estimating equations. This led to errors in tables 2, 3 and 4. The correct equation and revised tables are detailed below:
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Table 2.
Kidney function at ART initiation of adult patients starting tenofovir-containing ART with baseline eGFR available from two South African clinics
| Characteristic | MDRD | CKD-EPI | Cockroft-Gault | |
|---|---|---|---|---|
| All patients | ||||
| n | 13 396 | 13 396 | 11 868 | |
| eGFR (mL/min) (median, IQR) | 98.6 (84.4–115.6) | 110.4 (96.9–119.6) | 110.7 (91.4–133.7) | |
| Baseline eGFR category (n, %) | >90 | 8 769 (66) | 11 138 (83) | 9 105 (77) |
| 60–89 | 4 221 (32) | 2 065 (15) | 2 527 (21) | |
| 30–59 | 383 (3) | 177 (1) | 225 (2) | |
| 15–29 | 18 (0.1) | 12 (0.1) | 9 (0.1) | |
| <15 | 5 (0.04) | 4 (0.03) | 2 (0.02) | |
| Baseline and subsequent eGFR | ||||
| n | 11 112 | 11 112 | 9 283 | |
| eGFR (mL/min) (median, IQR) | 98.5 (84.5–115.1) | 110.4 (97.1–119.6) | 111.9 (92.8–134.9) | |
| Baseline eGFR category (n, %) | >90 | 7 273 (66) | 9 283 (84) | 7 267 (78) |
| 60–89 | 3 541 (32) | 1 701 (15) | 1 865 (20) | |
| 30–59 | 286 (3) | 120 (1) | 146 (2) | |
| 15–29 | 12 (0.1) | 8 (0.1) | 5 (0.1) | |
| <15 | 0 | 0 | 0 |
CKD-EPI: Chronic Kidney Disease Epidemiology Collaboration; MDRD: Modification of Diet in Renal Disease.
Table 3.
Predicted eGFR change from baseline in patients on tenofovir-containing ART from two South African clinics
| Change from baseline (mL/min) Mean (95% CI) | 3 months | 6 months | 12 months | 24 months |
|---|---|---|---|---|
| MDRD | ‒0.3 (‒0.4 to ‒0.2) | ‒0.7 (‒0.8 to ‒0.5) | ‒1.3 (‒1.7 to ‒1.0) | ‒2.6 (‒3.3 to ‒1.9) |
| n1 | 9 295 | 5 234 | 5 537 | 2 486 |
| CKD-EPI | ‒0.3 (‒0.3 to ‒0.2) | ‒0.5 (‒0.6 to ‒0.4) | ‒1.0 (‒1.2 to ‒0.8) | ‒2.0 (‒2.5 to ‒1.6) |
| n1 | 9 295 | 5 234 | 5 537 | 2 486 |
| Cockcroft-Gault | 1.0 (0.9 to 1.1) | 2.0 (1.8 to 2.2) | 4.0 (3.5 to 4.4) | 8.0 (7.1 to 8.9) |
| n1 | 7 405 | 3 165 | 4 446 | 1 632 |
CI: confidence interval; CKD-EPI: Chronic Kidney Disease Epidemiology Collaboration; MDRD: Modification of Diet in Renal Disease.
1. Patients who were on tenofovir at the relevant time point, and had at least one eGFR value available within 0.5–4.0 months (3 month time point); 4.1–8.0 months (6 month time point); 8.1–18.0 months (12 month time point); and 18.1–30.0 months (24 month time point). The linear mixed effects model used all eGFR data from all relevant patients to predict changes from baseline.
Table 4.
Predicted eGFR change from baseline according to baseline kidney function in patients on tenofovir-containing ART from two South African clinics
| Change from baseline Mean (95% confidence interval) |
3 months | 6 months | 12 months | 24 months |
|---|---|---|---|---|
| MDRD | ||||
| Baseline eGFR ≥90 mL/min | ‒1.1 (‒1.2 to ‒1.0) | ‒2.2 (‒2.4 to ‒2.0) | ‒4.4 (‒4.9 to ‒4.0) | ‒8.9 (‒9.8 to ‒7.9) |
| n1 | 6 033 | 3 418 | 3 607 | 1 558 |
| Baseline eGFR <90 mL/min | 4.9 (4.5 to 5.3) | 8.4 (7.8 to 9.1) | 11.9 (11.0 to 12.7) | 9.5 (8.4 to 10.5) |
| n1 | 3 262 | 1 816 | 1 930 | 928 |
| CKD-EPI | ||||
| Baseline eGFR ≥90 mL/min | ‒0.6 (‒0.6 to ‒0.5) | ‒1.1 (‒1.3 to ‒1.0) | ‒2.3 (‒2.5 to ‒2.1) | ‒4.6 (‒5.1 to ‒4.2) |
| n1 | 7 731 | 4 413 | 4 621 | 2 034 |
| Baseline eGFR <90 mL/min | 6.2 (3.8 to 6.7) | 10.6 (9.8 to 11.4) | 14.6 (13.5 to 15.7) | 10.7 (9.4 to 12.0) |
| n1 | 1 564 | 821 | 916 | 452 |
| Cockcroft-Gault | ||||
| Baseline eGFR ≥90 mL/min | 0.7 (0.5 to 0.8) | 1.4 (1.1 to 1.6) | 2.7 (2.2 to 3.2) | 5.4 (4.3 to 6.5) |
| n1 | 3 800 | 1 669 | 2 352 | 817 |
| Baseline eGFR <90 mL/min | 6.6 (6.0 to 7.2) | 11.7 (10.7 to 12.6) | 17.8 (16.5 to 19.1) | 18.8 (17.2 to 20.4) |
| n1 | 3 605 | 1 496 | 2 094 | 815 |
CI: confidence interval; CKD-EPI: Chronic Kidney Disease Epidemiology Collaboration; MDRD: Modification of Diet in Renal Disease.
1. Patients who were on tenofovir at the relevant time point, and had at least one eGFR value available within 0.5–4.0 months (3 month time point); 4.1–8.0 months (6 month time point); 8.1–18.0 months (12 month time point); and 18.1–30.0 months (24 month time point). The linear mixed effects model used all eGFR data from all relevant patients to predict changes from baseline.
Therefore: Amongst those with a baseline and subsequent eGFR available, mean eGFR change from baseline at 12 months was –4.4 mL/min (95% Cl −4.9 to −4.0), −2.3 (−2.5 to −2.1), and 2.7 (2.2 to 3.2) in those baseline eGFR ≥90 mL/min; and 11.9 mL/min (11.0 to 12.7), 14.6 (13.5 to 15.7), and 17.8 (16.5 to 19.1), in those with baseline eGFR <90 mL/min, according to the MDRD, CKD-EPI (n = 11 112), and Cockcroft-Gault (n = 9 283) equations, respectively.