肾小球滤过率评估公式的比较

Evaluation of equations for glomerular filtration rate

肾小球滤过率(GFR)是评价肾功能的重要指标,也是慢性肾脏病(CKD)分期的重要依据。使用公式评估GFR方法简便,已被广泛应用,其中Cockcroft-Gault(CG)公式和MDRD公式最为常用,CKD-EPI、改良MDRD公式、瑞金公式及基于胱抑素C的公式等次之,通过比较其偏差、精确度、准确性等指标发现,CG公式更适用于健康人群,但在肾功能不全患者适用性较差,且受体重影响明显;MDRD公式适用于肾功能不全患者,但在GFR水平较高时可靠性较差;CKD-EPI克服了MDRD公式在GFR较高时会低估真实值的缺点;改良MDRD公式和瑞金公式则更适用于中国人;而基于胱抑素C的公式在疾病早期有较好适用性。因此,尚需进一步改进或者发掘更好地评估GFR的公式。

Glomendar filtration rate （GFR） is an important index for evaluating kidney function, and also the important basis to classify for the chronic kidney disease （CKD）. The equations for evaluating GFR are simple and can be widely used, which are CG （Cockcroft-Gauh） equation, MDRD （ Modification of Diet in Renal Disease） equation, CKD- EPI, modified MDRD equation, Ruijin equation and cystatin equation. The aim of this review is to look for which equation is better to evaluate GFR. Through comparing their bias, precision, accuracy and other indices, which one is much better can determined. As a result, CG equation is better used in healthy people, but it is worse used in those who have kidney disease and it is affected by weight evidently. MDRD equation is better used in those of kidney disease, but it is worse used when GFR is high. CKD-EPI overcomes this disadvantage. Modified MDRD equation and ruijin equation are better used in Chinese people. Cystatin equation is better used in the early stage of kidney disease. No equation is perfect. So these equations need to be improved deeply or need to develop better equations to evaluate GFR.