评估肾小球滤过率增龄现象的研究

Assessment of the aging phenomenon of the glomerular filtration rate

目的:探寻一个估算公式能较为准确地反映肾小球滤过率(GFR)的增龄现象。方法:纳入2017年1月至2018年4月在南京医科大学第一附属医院接受体检的健康受试者作为研究对象,使用血清肌酐(Scr)等肾功能指标的增龄现象作为参考标准,评价4个基于Scr的GFR方程在GFR增龄过程中的准确性,包括全年龄段(FAS)公式、慢性肾脏病流行病学(CKD-EPI)公式、大阪公式和湘雅公式。结果:在37636例体检者中,6534例受试者符合本研究设定的标准。Scr、血清尿素氮、血清尿酸和血清白蛋白具有显著的增龄现象(H=191.640、196.693、83.271、414.585,均P<0.001)。由4个公式估测的GFR均随年龄增长而下降,但下降的起始年龄、速率存在显著差异,FAS公式估测的GFR增龄现象更接近于肾功能指标的趋势。结论:FAS公式可能更适用于健康人群来了解GFR的增龄现象。

Objective To construct an estimating equation to accurately reflect the aging phenomenon of the glomerular filtration rate(GFR).Methods Healthy subjects receiving physical examinations at the First Affiliated Hospital of Nanjing Medical University between January 2017 and April 2018 were included in the study,and the aging phenomenon of renal function indicators such as serum creatinine(Scr)was used as the reference standard to evaluate the accuracy of four Scr-based GFR equations during GFR aging,including the full age spectrum(FAS)equation,the Chronic Kidney Disease Epidemiology Collaboration(CKD-EPI)equation,the Osaka equation and the Xiangya equation.Results Of 37636 individuals receiving physical examinations,6534 met the criteria specified in this study.Scr,serum urea nitrogen,serum uric acid,and serum albumin showed a significant aging phenomenon(H=191.640,196.693,83.271,414.585,P<0.001 for all).The GFR estimated by the four equations all decreased with aging,but the starting point and rate of decline were significantly different.The GFR aging phenomenon estimated by the FAS equation was closer to the trend of renal function indicators.Conclusions The FAS equation may be more applicable to healthy people to understand the aging phenomenon of GFR.