The revised Lund-Malmo GFR estimating equation outperforms MDRD and CKD-EPI across GFR, age and BMI intervals in a large Swedish population
The revised Lund-Malmo GFR estimating equation outperforms MDRD and CKD-EPI across GFR, age and BMI intervals in a large Swedish population
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DOI：
10.1515/cclm-2013-0741
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发表时间：
2014-06-01
影响因子：
6.8
通讯作者：
Bjork, Jonas
中科院分区：
文献类型：
--
作者：
Nyman, Ulf;Grubb, Anders;Bjork, Jonas
背景：根据肾小球滤过率(GFR)、年龄和体重指数(BMI)定义的亚组，基于肌酐的肾小球滤过率(GFR)估算公式的性能可能不同。这项研究比较了修改肾脏疾病饮食(MDRD)研究和慢性肾脏疾病流行病学协作(CKD-EPI)方程与修正的Lund-Malmo方程(LM修订)的性能，一个新的方程有望更准确地处理GFR在整个生命周期的变化。方法：该研究纳入了2847名瑞典成年患者的3495次检查，这些患者2008-2010年通过血浆碘己醇清除量(中位数52mL/min/1.73m(2))测量GFR(MGFR)。结果：LM修订版/MDRD/CKD-EPI的总偏倚为2%/8%/11%，IQR12/14/14mL/min/1.73m(2)，P-10为40%/35%/35%，P-30为84%/75%/76%。无论性别，就偏倚、精密度和准确度而言，修正后的Lm是最稳定的方程，涉及mGFR、年龄和BMI间期。MDRD和CKD-EPI高估了肾功能减退患者、年轻人和老年人的mGFR。在BMI患者中，这三个方程都高估了mGFR，准确度较低
Background: The performance of creatinine-based glomerular filtration rate (GFR) estimating equations may vary in subgroups defined by GFR, age and body mass index (BMI). This study compares the performance of the Modification of Diet in Renal Disease (MDRD) study and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations with the revised Lund-Malmo equation (LM Revised), a new equation that can be expected to handle changes in GFR across the life span more accurately.Methods: The study included 3495 examinations in 2847 adult Swedish patients referred for measurement of GFR (mGFR) 2008-2010 by plasma clearance of iohexol (median 52 mL/min/1.73 m(2)). Bias, precision [interquartile range (IQR)] and accuracy [percentage of estimates +/- 10% (P-10) and +/- 30% (P-30) of mGFR] were compared.Results: The overall results of LM Revised/MDRD/CKD-EPI were: median bias 2%/8%/11%, IQR 12/14/14 mL/min/1.73 m(2), P-10 40%/35%/35% and P-30 84%/75%/76%. LM Revised was the most stable equation in terms of bias, precision and accuracy across mGFR, age and BMI intervals irrespective of gender. MDRD and CKD-EPI overestimated mGFR in patients with decreased kidney function, young adults and elderly. All three equations overestimated mGFR and had low accuracy in patients with BMI