CKD—EPI方程在我国慢性肾脏病不同分期中的应用

Application of CKD-EPI equation to estimate glomerular filtration rate in Chinese patients with chronic kidney disease in different stages

目的探讨慢性肾脏病流行病学合作研究（CKD-EPI）方程在中国人CKD的不同分期评估肾小球滤过率（GFR）的适用性。方法选择我院肾内科CKD患者98例。将CKl2vEPI方程估算的GFR值用体表面积（BSA）标准化得出估算GFR（eGFR），与BsA标准化的肾动态显像法（^99Tc-DTPA）检测的GFR（sGFR）用K／DOOI指南推荐的方法进行比较。结果相关性分析得出eGFR与sGFR呈正相关（r=0．847，P〈0．01）；eGFR的15％、30％及50％符合率分别是31．6N、59．2％和85．7％，eGFR估计值与sGFR平均偏差2．56ml／min。CKD各期偏差均无统计学意义，在CKD2～5期，偏差较小；CKD1期，偏差略大，偏差值为（13．22±22．41），但偏差无统计学意义（P〉0．05）。结论CKD-EPI方程可广泛应用于我国CKD各期患者评估GFR，具有较小的偏差，较高的准确性。CKD-EPI方程在评估较高的GFR时，可能存在矫枉过正，高估GFR。

Objective To evaluate the applicability of the Chronic Kidney Disease Epidemiology Collaboration （CKD-EPI） equation to estimate glomerular filtration rate in Chinese patients with CKD in different stages. Methods Ninety-eight patients with CKD were investigated. The estimated GFR （eGFR） from CKD-EPI equation-estimated GFR standardized by BSA was compared with BSA-stand- ardized sGFR measured by ^99Tc-DTPA renal dynamic imaging method. Results Correlation analysis revealed eGFR was positively correlated with sGFR （r= 0. 847, P〈0. 001）. 15%, 30% and 50% coincidence rate of eGFR was 31.6%, 59. 2% and 85.7% respectively. Average deviation of eOFR from sGFR was 2. 56 （mL/min）. There was no significant deviation in all stages of CKD. In the stages 2-5 of CKD, the deviations were smaller; and in the stage 1 of CKD, the deviation was slightly larger （ 13.22 ± 22. 41 ）. Conclusions CKD-EPI equation can be widely used in evaluation of GFR in patients with CKD in different stages, with a less deviation, higher accuracy. When estimating GFR at higher values, it may be overcorrected or overestimated by CKD-EPI equation.