肾小球滤过率评估方程在中青年慢性肾脏病人中的适用性

Evaluation on glomerular filtration rate estimated with three equations in Chinese young and middle-aged patients with chronic kidney disease.

目的探讨肾小球滤过率(GFR)评估方程在我国中青年慢性肾脏病(CKD)患者中的适用性。方法选择102例中青年慢性肾脏病患者,将Cockcroft-Gault方程、MDRD7方程、简化MDRD方程计算的GFR值用体表面积(BSA)标准化与BSA标准化的99mTc-DTPA测得的GFR在不同CKD分期进行比较。结果方程计算的GFR(cGFR、7GFR、aGFR)与99mTc-GFR(sGFR)均具有显著的相关性,相关性较好的依次为MDRD7、简化MDRD和Cockcroft-Gault方程;在Roc曲线下的平均面积上述三个公式分别是0.86、0.83和0.80。cGFR、7GFR、aGFR与99mTc-GFR差异均有显著意义(P<0.01)。结论上述方程用于我国CKD患者时,应对其进行适当修正。

Objective To evaluate the applicability of three equations of glomerular filtration rate in Chinese young and middle-aged patients with chronic kidney disease （CKD）. Methods CKD were diagnosed according to K/DOQI guideline. 102 patients with CKD were selected. Glomerular filtration rates （GFR） estimated with MDRD seven equation, abbreviated MDRD equation, and Cockcroft-Gauh （CG） equation were compared with ^99mTc-DTPA plasma clearance （sGFR） in different stages of CKD. The GFRs were standarded by body surface area .Results The GFRs of the three equations were correlated significantly with sGFR. MDRD seven equation seemed to be the best, abbreviated MDRD equation was the second, CG equation was the last. The mean area under Roc curve of MDRD seven equation, abbreviated MDRD equation and CG equation was 0.84, 0.82, and 0.79 respectively. There was significant difference between GFR estimated with three equations and sGFR in different stage of CKD. Conclusion The three equations for estimation of GFR should be amended when applying to Chinese patients with CKD.