CKD Prediction in HIV Positive Patients

By /
CKD Prediction in HIV+ Patients
Renal risk prediction

CKD Prediction in HIV+ Patients

Estimates the approximate probability of developing chronic kidney disease within 5 years and compares the observed risk with and without tenofovir disoproxil fumarate (TDF) exposure.

Enter patient information

All fields are required. The score ranges from 0 to 15 points.

Validated age range in the original cohort: 19–90 years.
years
Glucose >140 mg/dL (7.77 mmol/L) Use the available baseline plasma glucose result.
Systolic BP >140 mmHg Based on the baseline systolic blood pressure.
Hypertension Documented diagnosis of hypertension.
Triglycerides >200 mg/dL (>2.26 mmol/L) Use the available baseline triglyceride result.
Proteinuria Proteinuria present on baseline clinical or laboratory assessment.
CD4+ count <200 cells/µL Use the baseline CD4+ cell count.
Past or present TDF use Tenofovir disoproxil fumarate exposure in the original model was classified as ever versus never use.
This model concerns tenofovir disoproxil fumarate (TDF), not tenofovir alafenamide (TAF). Do not apply the TDF risk estimate to TAF.
CKD risk score
0
out of 15 points

Approximate 5-year CKD risk

—
Never TDF —
Ever TDF —
Absolute difference —
Approx. NNH over 5 years —

Interpretation

Point breakdown

    How the score is calculated

    • Age 19–39: 0 points; 40–49: 2; 50–59: 4; 60–90: 6.
    • Glucose >140 mg/dL: +2 points.
    • Systolic BP >140 mmHg: +1 point.
    • Hypertension: +2 points.
    • Triglycerides >200 mg/dL: +1 point.
    • Proteinuria: +2 points.
    • CD4+ count <200 cells/µL: +1 point.

    Important limitations

    • Derived from HIV-positive male U.S. veterans initiating antiretroviral therapy.
    • The original cohort excluded baseline eGFR <60 mL/min/1.73 m² and included ages 19–90.
    • The model was not originally validated in women, children, non-veterans, PrEP users, or patients taking TDF for hepatitis B.
    • Use alongside current HIV guidance, renal monitoring, medication review, and clinical judgment.
    Evidence source: Scherzer R, Gandhi M, Estrella MM, et al. A chronic kidney disease risk score to determine tenofovir safety in a prospective cohort of HIV-positive male veterans. AIDS. 2014;28(9):1289–1295. The point assignments are from the published model. The displayed intermediate 5-year event rates are rounded approximations digitized from Figure 1; the article text explicitly confirms the score-8 values and the 0-point/9+ endpoints. Scores of 9–15 use the pooled “9+” risk category.

    Related Posts

    Leave a Comment

    Your email address will not be published. Required fields are marked *

    Scroll to Top