基于肌酐的GFR估算公式在中国亲属活体肾移植受体术后肾功能评价中的效用比较

Comparison of five creatinine-based glomerular filtration rateestimating equations on renal function evaluation in Chinese living related donor renal transplant recipients

目的 :评估与比较5种以血清肌酐(Scr)为基础的肾小球滤过率(glomerular filtration rate,GFR)估算公式在中国亲属活体肾移植受体肾功能评估中的效用。方法:选取39例在本院行亲属活体肾移植且肾功能稳定的肾移植受体,以99m Tc-DTPA肾功能动态显像技术(ECT)测定的GFR(reference GFR,r GFR)作为基准,比较5种以血清肌酐(Scr)为基础GFR估算公式在亲属活体肾移植受体肾功能评估中的偏倚(bias)、精度(precision)和基准试验结果 30%及50%的精确度(accuracy)。结果:以日本肾脏病协会-慢性肾脏病组织公式(Japanese Society of Nephrology-Chronic Kidney Disease Initiatives,JSN-CKDI)具有最高的精确度(30%精确度:71.8%),仅有-0.7 ml/(min·1.73m2)的偏倚,而精度为12.0 ml/(min·1.73m2)。结论 :在中国亲属活体肾移植受者术后长期随访中,以血清肌酐(Scr)为基础的JSN-CKDI公式可能是评估及监测移植肾GFR的最佳选择。

Objective：The aim of this study was to evaluate 5 creatine（Scr）-based glomerular filtration rate（GFR）estimating equations on renal function evaluation in Chinese living related donor transplantation recipients. Methods：We compared 5 Scr-based GFR estimating equations using GFR measurement of99mTc-DTPA as the reference test in 39 stable renal transplantation populations from living related donor in our hospital. Bias,precision,accuracy within 30% and 50% ranges from the reference method and agreements of each test were compared. Results：The Scr-based Japanese Society of Nephrology-Chronic Kidney Disease Initiatives（JSN-CKDI） equation had the highest accuracy（71.8% within 30% of the reference）with a bias of only-0.7 ml /（min·1.73m^2）and a precision of 12.0 ml /（min·1.73m^2）. Conclusion：Scr-based JSN-CKDI equation may be the best choice for assessing and monitoring GFR of long-term postoperative Chinese renal transplant recipients.