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Treatment of Key Populations and Unique Situations

Treatment of HCV in Persons with Renal Impairment

Activity 2B. GFR Calculator

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Learning Objective Performance Indicators

  • Explain the impact of HCV on renal disease
  • Summarize the main findings from HCV treatment studies in people with renal disease
  • Discuss dosing of direct-acting antiviral medications in persons with chronic renal disease
  • Describe appropriate HCV treatment in persons prior to renal transplantaton
  • Summarize HCV treatment recommendations in persons following renal transplantation

Instructions

A 55-year-old woman is seen to begin therapy for chronic HCV genotype 2 infection. She is African-American and her weight is 61 kg. Her serum creatinine is 1.27 mg/dL.

Using the GFR Calculator tool below (which can also be found by clicking on the Clinical Calculators tab in the top navigation bar), obtain an estimate of this patient's GFR and then answer the Activity Question below.

2021 CKD-EPI Adult eGFR Calculator

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Sex:

Age (years):

Serum creatinine (mg/dL):

You can provide the serum creatinine, serum cystatin c, or both.
+

Serum cystatin C (mg/L):

You can provide the serum creatinine, serum cystatin c, or both.
+
eGFRcr:eGFRcr-cys:eGFRcys:mL/min/1.73 m2


CKD-EPI Adult eGFR Equation

Depending on which variables are provided, one of the following equations will be utilized:

  • eGFRcr = 142 × min(SCr/κ,1)α × max(SCr/κ,1)-1.2 × 0.9938Age × 1.012 (if female)
    • κ = 0.7 (females) or 0.9 (males)
    • α = -0.241 (females) or -0.302 (males)
  • eGFRcys = 133 × min(Scys/0.8,1)-0.499 × max(SCr/0.8,1)-1.328 × 0.996Age × 0.932 (if female)
  • eGFRcr-cys = 135 × min(SCr/κ,1)α × max(SCr/κ,1)-0.544 × min(Scys/0.8,1)-0.323 × max(Scys/0.8,1)-0.778 × 0.9961Age × 0.963 (if female)
    • κ = 0.7 (females) or 0.9 (males)
    • α = -0.219 (females) or -0.144 (males)

Notes: This Chronic Kidney Disease Epidemiology (CKD-EPI) calculator is for adults (people ages 18 and older). This calculator uses the race-free 2021 CKD-EPI equations to estimate GFR. The development of this calculator was led by Dr. Andrew S. Levy and Dr. Lesley A. Inker. Cystatin C is not available in all laboratories and most patients can be monitored with serum creatinine alone.

Sources

  • Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999;130:461-70.
  • Levey AS, Coresh J, Greene T, et al. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006;145:247-54.

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No input variables or data is transmitted between your computer and our servers.

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Activity Question

You should answer this question after completing the activity.

You must answer all of the questions before checking your work.

What is this woman's estimated GFR?

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