Performance of chronic kidney disease epidemiology collaboration creatinine-cystatin C equation for estimating kidney function in cirrhosis.
Performance of chronic kidney disease epidemiology collaboration creatinine-cystatin C equation for estimating kidney function in cirrhosis.
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DOI：
10.1002/hep.26556
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发表时间：
2014-04
期刊：
影响因子：
13.5
通讯作者：
Magder, Laurence S.
中科院分区：
文献类型：
--
作者：
Mindikoglu, Ayse L.;Dowling, Thomas C.;Weir, Matthew R.;Seliger, Stephen L.;Christenson, Robert H.;Magder, Laurence S.
传统的以肌酐为基础的肾小球滤过率(GFR)公式不能很准确地估计肝硬变患者的GFR。慢性肾脏疾病流行病学协作组(CKD-EPI)最近提出了一个公式，可以同时使用血清肌酐和胱抑素C水平来估计非肝硬化组的GFR。新的CKD-EPI肌酐-胱抑素C方程(2012)的性能优于以前基于肌酐或胱抑素C的GFR方程。为了评价CKD-EPI肌酸-胱抑素C方程在肝硬变患者中的应用，我们比较了72例肝硬变患者的CKD-EPI肌酸-胱抑素C方程与非放射性标记硫代氨基甲酸盐血浆清除率(MGFR)测定的GFR。我们比较了新的CKD-EPI肌酐-胱抑素C方程与24小时尿肌酐清除量(CrCl)、Cockcroft-Gault(CG)和先前报道的基于肌酐和/或胱抑素C的GFR估计方程的“偏差”、“精密度”和“准确度”。CKD-EPI肌酸-胱抑素C方程的准确度[各受试者MGFR与估计GFR、MGFR与CrCl、MGFR与CG方程之间的差值]的均方根误差(RMSE=23.56)明显好于CrCl37.69(P=0.001)、CG(RMSE=36.12，P=0.002)和仅基于胱抑素C的GFR估计方程。以与mGFR相差大于30%的EGFR百分比来量化其准确性，其准确性明显好于CrCl4(P=0.024)、CG(P=0.0001)、4变量MDRD(P=0.027)和CKD-EPI肌酸酐2009年(P=0.012)方程。然而，对于23.61%的受试者，由CKD-EPI肌酐-胱抑素C方程估计的GFR与mGFR相差超过30%。CKD-EPI-肌酐-胱抑素C方程(2012)对肝硬变患者的诊断性能优于传统方程在估计GFR方面的临床应用。然而，它的诊断性能比报道的非肝硬变患者要差得多。
Conventional creatinine-based glomerular filtration rate (GFR) equations are insufficiently accurate for estimating GFR in cirrhosis. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) recently proposed an equation to estimate GFR in subjects without cirrhosis using both serum creatinine and cystatin C levels. Performance of the new CKD-EPI creatinine-cystatin C equation (2012) was superior to previous creatinine- or cystatin C-based GFR equations. To evaluate the performance of the CKD-EPI creatinine-cystatin C equation in subjects with cirrhosis, we compared it to GFR measured by non-radiolabeled iothalamate plasma clearance (mGFR) in 72 subjects with cirrhosis. We compared the “bias”, “precision” and “accuracy” of the new CKD-EPI creatinine-cystatin C equation to that of 24-hour urinary creatinine clearance (CrCl), Cockcroft-Gault (CG) and previously reported creatinine- and/or cystatin C-based GFR-estimating equations. Accuracy of CKD-EPI creatinine-cystatin C equation as quantified by root mean squared error of difference scores [differences between mGFR and estimated GFR (eGFR) or between mGFR and CrCl, or between mGFR and CG equation for each subject] (RMSE=23.56) was significantly better than that of CrCl (37.69, P=0.001), CG (RMSE=36.12, P=0.002) and GFR-estimating equations based on cystatin C only. Its accuracy as quantified by percentage of eGFRs that differed by greater than 30% with respect to mGFR was significantly better compared to CrCl (P=0.024), CG (P=0.0001), 4-variable MDRD (P=0.027) and CKD-EPI creatinine 2009 (P=0.012) equations. However, for 23.61% of the subjects, GFR estimated by CKD-EPI creatinine-cystatin C equation differed from the mGFR by more than 30%. The diagnostic performance of CKD-EPI creatinine-cystatin C equation (2012) in patients with cirrhosis was superior to conventional equations in clinical practice for estimating GFR. However, its diagnostic performance was substantially worse than reported in subjects without cirrhosis.
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影响因子：
--
作者：
Du Bois, D;Du Bois, EF
通讯作者：
Du Bois, EF
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
DOI：
10.1080/00365510410003723
发表时间：
2004-02-01
影响因子：
2.1
作者：
Larsson, A;Malm, J;Hansson, LO
通讯作者：
Hansson, LO
影响因子：
24.5
作者：
Gerbes, AL;Gülberg, V;Vogeser, M
通讯作者：
Vogeser, M
影响因子：
15.9
作者：
LESLIE, SH;JOHNSTON, B;RALLI, EP
通讯作者：
RALLI, EP