cliot (version 1.0.0)

ckd_prediction_hiv: CKD Prediction in HIV Patients (D:A:D Score)

Description

Calculates the D:A:D (Data Collection on Adverse Events of Anti-HIV Drugs) Risk Score for Chronic Kidney Disease. This tool estimates the 5-year risk of developing CKD (defined as confirmed eGFR < 60 mL/min/1.73 m^2) in HIV-positive patients with a baseline eGFR > 60.

Usage

ckd_prediction_hiv(age, sex, iv_drug_user, baseline_egfr, current_cd4,
                   nadir_cd4, viral_load, hepatitis_c, history_cvd,
                   hypertension, diabetes)

Value

A list containing:

DAD_CKD_Score

The calculated risk score.

Risk_Category

Risk stratification (Low < 10, Medium 10-19, High >= 20).

Five_Year_Risk_Ratio

Estimated 5-year probability of developing CKD expressed as a ratio (e.g., 1:32).

Arguments

age

Numeric. Patient age in years.

sex

String. "Male" or "Female". (Male adds +1 point).

iv_drug_user

Numeric (0 or 1). History of Injection Drug Use. (1 = Yes, +3 points).

baseline_egfr

Numeric. Baseline eGFR in mL/min/1.73 m^2. Must be >= 60. (Lower eGFR values add more points).

current_cd4

Numeric. Current CD4 count in cells/mm^3. (<50: +3 pts; 50-199: +2 pts).

nadir_cd4

Numeric. Nadir (lowest historical) CD4 count in cells/mm^3. (<50: +2 pts; 50-199: +1 pt).

viral_load

Numeric. HIV RNA Viral Load in copies/mL. (>100,000 copies/mL adds +2 points).

hepatitis_c

Numeric (0 or 1). Hepatitis C Coinfection (Positive antibody or RNA). (1 = Yes, +1 point).

history_cvd

Numeric (0 or 1). History of Cardiovascular Disease. (1 = Yes, +2 points).

hypertension

Numeric (0 or 1). History of Hypertension. (1 = Yes, +2 points).

diabetes

Numeric (0 or 1). History of Diabetes Mellitus. (1 = Yes, +4 points).

References

Mocroft A, Kirk O, Reiss P, et al. Estimated glomerular filtration rate, chronic kidney disease and antiretroviral drug use in HIV-positive patients. AIDS. 2010;24(11):1667-1678. doi:10.1097/QAD.0b013e328339fe53

Examples

# Example 1: High Risk
# 60yo Male (+12), eGFR 65 (+15), DM (+4)
# Score = 11 + 1 + 15 + 4 = 31
ckd_prediction_hiv(60, "male", 0, 65, 500, 200, 50, 0, 0, 0, 1)

# Example 2: Low Risk
# 30yo Female, eGFR 100, No comorbidities
# Score = 0
ckd_prediction_hiv(30, "female", 0, 100, 500, 300, 0, 0, 0, 0, 0)