Multicenter study of creatinine- and/or cystatin C-based equations for estimation of glomerular filtration rates in Chinese patients with chronic kidney disease.
Multicenter study of creatinine- and/or cystatin C-based equations for estimation of glomerular filtration rates in Chinese patients with chronic kidney disease.
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DOI：
10.1371/journal.pone.0057240
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Duan R
中科院分区：
文献类型：
--
作者：
Feng JF;Qiu L;Zhang L;Li XM;Yang YW;Zeng P;Guo XZ;Qin Y;Liu HC;Han XM;Li YP;Xu W;Sun SY;Wang LQ;Quan H;Xia LJ;Hu HZ;Zhong FC;Duan R
建立基于血清肌酐（SCr）和/或血清胱抑素C（SCysC）的中国慢性肾脏病（CKD）患者肾小球滤过率（eGFR）估算公式，并与参考GFR（rGFR）和文献公式进行比较，评价新公式的适用性。 将788例CKD患者随机分为训练组和试验组，分别建立基于血清CysC的新的eGFR公式和验证公式。测定所有患者的99 mTc-DTPA清除率（作为rGFR）、血清Cr和血清CysC，并使用Cockcroft-Gault公式（eGFR 1）、MDRD公式（eGFR 2）、CKD-EPI公式（eGFR 3、eGFR 4）和中国eGFR研究协作组公式（eGFR 5、eGFR 6）计算GFR。将每个eGFR的准确性与rGFR进行比较。 训练组和测试组的平均GFR分别为50.84±31.36 mL/min/1.73 m2和54.16±29.45 mL/min/1.73 m2。使用迭代计算拟合两个新开发的eGFR公式：和。在每个eGFR和rGFR之间观察到显著相关性。然而，如Passing & Bablok图分析所示，在rGFR和eGFR 1、eGFR 2、eGFR 4、eGFR 5或eGFR 6之间观察到比例误差和恒定误差，在eGFR 3和rGFR之间观察到恒定误差。Bland-Altman分析表明，除eGFR 7和eGFR 8的方程外，所有方程的95%一致性限度均超过先前接受的限度（<60 mL/min ·1.73 m2）。 新开发的公式eGFR 7和eGFR 8单独使用血清CysC检测或与血清Cr检测联合使用，可提供精确和准确的GFR估计。在选择文献eGFR方程时应慎重考虑检测方法的差异，避免误诊误治。
To establish equations for the estimation of glomerular filtration rates (eGFRs) based on serum creatinine (SCr) and/or serum cystatin C (SCysC) in Chinese patients with chronic kidney disease (CKD), and to compare the new equations with both the reference GFR (rGFR) and the literature equations to evaluate their applicability. The 788 Chinese CKD patients were randomly divided into two groups, the training group and the testing group, to establish new eGFR-formulas based on serum CysC and to validate the established formulas, respectively. 99mTc-DTPA clearance (as the rGFR), serum Cr, and serum CysC were determined for all patients, and GFR was calculated using the Cockcroft-Gault equation (eGFR1), the MDRD formula (eGFR2), the CKD-EPI formulas (eGFR3, eGFR4), and the Chinese eGFR Investigation Collaboration formulas (eGFR5, eGFR6). The accuracy of each eGFR was compared with the rGFR. The training and testing groups' mean GFRs were 50.84±31.36 mL/min/1.73 m2 and 54.16±29.45 mL/min/1.73 m2, respectively. The two newly developed eGFR formulas were fitted using iterative computation: and . Significant correlation was observed between each eGFR and the rGFR. However, proportional errors and constant errors were observed between rGFR and eGFR1, eGFR2, eGFR4, eGFR5 or eGFR6, and constant errors were observed between eGFR3 and rGFR, as revealed by the Passing & Bablok plot analysis. The Bland-Altman analysis illustrated that the 95% limits of agreement of all equations exceeded the previously accepted limits of <60 mL/min •1.73 m2, except the equations of eGFR7 and eGFR8. The newly developed formulas, eGFR7 and eGFR8, provide precise and accurate GFR estimation using serum CysC detection alone or in combination with serum Cr detection. Differences in detection methods should be carefully considered when choosing literature eGFR equations to avoid misdiagnosis and mistreatment.
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DOI：
10.1056/nejmoa1114248
发表时间：
2012-07-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Inker LA;Schmid CH;Tighiouart H;Eckfeldt JH;Feldman HI;Greene T;Kusek JW;Manzi J;Van Lente F;Zhang YL;Coresh J;Levey AS;CKD-EPI Investigators
通讯作者：
CKD-EPI Investigators
影响因子：
19.6
作者：
Levey, AS;Eckardt, KU;Eknoyan, G
通讯作者：
Eknoyan, G
影响因子：
2.8
作者：
Bargnoux, A. S.;Servel, A. C.;Cristol, J. P.
通讯作者：
Cristol, J. P.
影响因子：
1.6
作者：
Kotajima, N.;Yanagawa, Y.;Murakami, M.
通讯作者：
Murakami, M.
影响因子：
2.1
作者：
Krishnamurthy, N.;Arumugasamy, K.;Venu, G.
通讯作者：
Venu, G.