CKD-EPI方程估算中国慢性肾脏病患者肾小球滤过率的适用性评价

Application of the CKD-EPI equation for estimation of glomerular filtration rate in Chinese patients with chronic kidney disease

目的评价慢性肾脏病流行病合作工作组(the chronic kidney disease epidemiology collaboration,CKD-EPI)方程是否比简化肾脏病饮食调整工作组(the modification of diet in renal disease study,MDRD)方程和中国改良简化MDRD方程更适合估算中国慢性肾脏病(chronic kidney disease,CKD)患者肾小球滤过率(glomerular filtrationrate,GFR)。方法收集2009年9月～2012年6月在安徽医科大学第二附属医院住院的304例CKD患者纳入本研究,收集患者的一般人口特征、临床资料、血浆肌酐值和99mTc-DTPA肾动态显像资料。以99mTc-DTPA肾动态显像法所测肾小球滤过率(rGFR)为GFR的金标准,用CKD-EPI方程、简化MDRD方程和中国改良简化MDRD方程估算肾小球滤过率分别为cGFR、mGFR和c-aGFR,比较3方程的估计偏差、精确性、准确性和一致性。结果与中国改良简化MDRD方程相比,CKD-EPI方程降低了估测偏差中位数,提高了精确性、一致性及15%、30%和50%准确性。与简化MDRD方程相比,CKD-EPI估计值提高了30%和50%准确性。结论 CKD-EPI方程可能比简化MDRD方程和中国改良简化MDRD方程更适用于评估中国CKD患者GFR。

Objective To evaluate whether the chronic kidney disease epidemiology collaboration （CKD-EPI） e- quation could be more accurate than the abbreviated modification of diet in renal disease study （MDRD） equation and the Chinese modified abbreviated MDRD equation in estimating glomerular filtration rate （GFR） in Chinese patients with chro- nic kidney disease （CKD）. Methods 304 patients with CKD hospitalized in the second hospital of Anhui medical univer- sity from September 2009 to June 2012 were enrolled in this study. Demographic and clinical characteristics and serum cre- atinine were collected. GFR measured by dynamic renal imaging with 99 mTc-DTPA was used as the reference value （rG- FR）. GFR was estimated by the CKD-EPI equation, the abbreviated MDRD equation and the Chinese modified abbreviated MDRD equation （ cGFR, mGFR and c-aGFR）. The bias, accuracy, precision and agreement were compared between CKD-EPI equation and other two equations. Results Compared with the Chinese modified abbreviated MDRD equation, CKD-EPI equation had lower bias,better agreement, and greater 15%, 30% and 50% accuracy ivith the measured value. CKD-EPI equation increased 30% and 50% accuracy, as compared with the abbreviated MDRD study equation. Conclusions The CKD-EPI equation may be more suitable for the estimation of GFR in Chinese patients with CKD.