Comparison of MDRD, CKD-EPI, and Cockcroft-Gault equation in relation to measured glomerular filtration rate among a large cohort with diabetes
Comparison of MDRD, CKD-EPI, and Cockcroft-Gault equation in relation to measured glomerular filtration rate among a large cohort with diabetes
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DOI：
10.1016/j.jdiacomp.2017.06.016
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发表时间：
2017-09-01
影响因子：
3
通讯作者：
Holl, Reinhard W.
中科院分区：
文献类型：
--
作者：
Schwandt, Anke;Denkinger, Michael;Holl, Reinhard W.
目的：分析饮食改变在肾病（MDRD）、慢性肾病流行病学协作（CKD-EPI）、Cockcroft-Gault （CG）和理想体重（CG- ibw）方程计算的CG在大型糖尿病人群中基于血清肌酐估计肾小球滤过率（eGFR）的作用。方法：对来自多中心糖尿病前瞻性随访登记DPV的24,516例1型或2型糖尿病成人患者进行分析。我们通过计算平均偏差（差值）、精度（差值的标准差）、准确性（eGFR在mGFR +/- 10%内的比例）、bland - altman图，比较了24小时尿液收集的eGFR和测量的GFR （mGFR）。结果：CG高估，而MDRD、CKD-EPI和CG- ibw低估。与其他方程相比，MDRD的平均偏差最小，准确率最高（753%）（p < 0.0001）。MDRD和CID-EPI在1期（MDRD:57.7%, CKD-EPI:57.3%）和2期（MDRD:80.2%, CKD-EPI:80.7%）估计最准确。在3至5期，MDRD的准确率最高（3期823%，4期77.8%，5期71.0%）。在年轻的受试者中，使用CKD-EP1的准确性更高(18-
Aims: To analyze the performance of Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Cockcroft-Gault (CG), and CG calculated with ideal bodyweight (CG-IBW) equations to estimate glomerular filtration rate (eGFR) based on serum creatinine in a large diabetic population.Methods: 24,516 adults with type-1-diabetes or type-2-diabetes from the multicenter diabetes prospective follow-up registry DPV were analyzed. We compared eGFR and measured GFR (mGFR) based on 24-h urine collection by calculating mean bias (difference), precision (SD of this difference), accuracy (proportion of eGFR within +/- 10% of mGFR), Bland-Altman-plots.Results: CG overestimates, whereas MDRD, CKD-EPI, and CG-IBW underestimate. Smallest mean bias and highest accuracy (753%) were observed for MDRD compared to the other equations (p < 0.0001). MDRD and CID-EPI estimated most accurately in stages 1 (MDRD:57.7%, CKD-EPI:57.3%) and 2 (MDRD:80.2%, CKD-EPI:80.7%). In stages 3 to 5, highest accuracy was observed for the MDRD (stage 3:823%, stage 4:77.8%, stage 5:71.0%). Among younger subjects, accuracy was higher using the CKD-EP1 (18-