高龄慢性肾脏病患者肾小球滤过率估算公式比较

A comparison of estimated glomerular filtration rate equations in very elderly patients with chronic kidney disease

目的研究常用的肾小球滤过率估算公式在老龄慢性肾脏病(CKD)患者中的适用性。方法以同位素显像法测定的患者肾小球滤过率为标准,评价常用的肾小球滤过率估算公式用于334例高龄CKD患者的精确度和准确度。结果目前最常用的CG和MDRD系列公式在估算高龄CKD患者肾小球滤过率时均无法达到临床需要的估算效能。经过数据转换,可以改善这些公式的精确度和准确度。结论在以常用的肾小球滤过率公式评价高龄CKD患者肾功能时需审慎,建议个体化选用公式,适当数据转换,必要时直接测定肾小球滤过率或内生肌酐清除率。

Objective To compare the performances of commonly-used estimated glomerular filtration rate equations in very elderly patients with chronic kidney disease.Methods Isotope scanning GFR as golden standard,the precision and accuracy of several commonly-used estimated glomerular filtration rate equations were evaluated in 334 very elderly patients with chronic kidney disease.Results The performances of CG or MDRD equations were unsatisfying.Data transformation might improve the performance.Conclusions It should be prudent when using CG or MDRD equations to estimate the glomerular filtration rates of very elderly patients with chronic kidney disease.Individual choose of equations,proper data transformation and direct investigation of glomerular filtration rate or creatinine clearance rate should be used if necessary.