4个肾小球滤过率估计公式的人群实证研究

An empirical research of four equations for estimated glomerular filtration rate among mass samples

目的通过使用不同的肾小球滤过率（GFR）公式估计人群的估计GFR（eGFR），了解不同公式的特征，指导正确选用公式有效估计eGFR。方法本研究使用徐州地区近年来健康体检者的资料，比较简化MDRD公式、国内改良MDRD公式、种族系数公式和瑞金方程，比较各种统计指标之间的差异，通过图表的动态变化来判断各公式的价值。结果简化MDRD公式的eCFR值与国内改良MDRD公式接近，瑞金方程最低，种族系数公式最高。肾功能下降标化患病率依次为0．53％、0．45％、0．62％、0．17％，慢性肾脏病（CKD）标化患病率依次为11．71％、11．66％、11．81％、11．46％。结论人群研究中CKD的主体在血尿和蛋白尿，选用不同公式对CKD研究带来的偏倚比较小。在没有新的生化指标取代血肌酐之前，建议继续使用影响最广的简化MDRD公式或者改良MDRD公式，以便于各研究之间的横向和纵向比较。

Objective To investigate the features of each glomerular filtration rate （GFR） equation in calculating the estimated glomerular filtration rate （eGFR） among mass samples, and to provide guidance to the appropriate equation selections of in the estimation of eGFR. Methods The mass samples were based on the physical examination data in recent years in Xuzhou. Simplifed MDRD equation, modified MDRD equation, racial coefficient equation and Ruijin equation were designated to compare differences in statistic indexes and evaluate each equation via dynamic diagrammatic trends. Results Of the four equations, the means of eGFR by simplified MDRD equation were approximate to those by modified MDRD equation, with those by Ruijin equation at the nadir and those by racial coefficient equation at the peak. The standardized rate of reduced renal function was 0.53% , 0.45% , 0.62% and 0. 17%, respectively. The standardized rate of chronic kidney disease （CKD） was 11.71% , 11.66% , 11.81% and 11.46%, respectively. Conclusion The CKD in population study consists in hematuria and proteinuria, with little bias between different equations. Simplified MDRD equation or modified MDRD equation is still preferable in the study of the prevalence of CKD until new biochemical indicator is adopted to substitute serum creatinine so as to facilitate horizontal and vertical comparisons among relevant studies.