Evaluation of the Chronic Kidney Disease Epidemiology Collaboration equation for estimating the glomerular filtration rate in multiple ethnicities.
Evaluation of the Chronic Kidney Disease Epidemiology Collaboration equation for estimating the glomerular filtration rate in multiple ethnicities.
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DOI：
10.1038/ki.2010.462
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发表时间：
2011-03
影响因子：
19.6
通讯作者：
Levey AS
中科院分区：
文献类型：
--
作者：
Stevens LA;Claybon MA;Schmid CH;Chen J;Horio M;Imai E;Nelson RG;Van Deventer M;Wang HY;Zuo L;Zhang YL;Levey AS
与 MDRD 研究方程相比，CKD-EPI 方程减少了 GFR 估计的偏差并提高了准确性。肌酐的生成因种族而异，但两个方程仅考虑黑人与其他人。我们开发并验证了一个包含 4 级种族变量的 GFR 估计方程。方程是根据 10 项研究 (N=8254) 的汇总数据建立的，并在来自美国和欧洲的另外 17 项研究 [CKD-EPI 验证数据库 (N=4014)] 以及来自中国 (N=675)、日本 (N=248) 和南非 (N=99) 的研究中得到验证。种族被定义为 2 级变量（黑人与其他人）和 4 级变量（黑人、亚洲人、美洲原住民和西班牙裔与其他人）。与其他人相比，黑人、亚洲人、美洲原住民和西班牙裔的系数导致估计 GFR 水平分别高出 15%、5% 和 1%。 2 水平种族方程在黑人、美洲原住民、西班牙裔和其他人中的偏差最小[CKD-EPI 验证数据库中分别为−0.8 (−2.0,0.6)、2.3 (−2.1,5.1) 和 2.8 (2.4,3.2) ml/min/1.73 m2]。 4 级种族方程改善了 CKD-EPI 亚洲人（0.8 (−2.2,2.6) vs 2.1 (0.3,4.4) ml/min/1.73 m2）和中国人（1.3 (0.6,2.2) vs 2.7 (1.9,3.7) ml/min/1.73 m2）的偏差。这两个方程在日本人 [−17.8 (−0.1,−14.7) 和 −21.4 (−23.2,−18.2) ml/min/1.73 m2)] 和南非人 [−12.4 (−18.3,−7.6) 和 −12.5 (−18.3,−7.6) ml/min/1.73 m2] 中存在很大偏差。在一个地理区域开发的种族多级变量可能不适用于其他区域。 CKD-EPI 方程中的 2 级种族变量可用于美国和欧洲的所有种族群体。
The CKD-EPI equation reduces bias and improves accuracy for GFR estimation compared to the MDRD Study equation. Creatinine generation differs among racial-ethnic groups but both equations only consider Blacks vs other. We developed and validated a GFR-estimating equation that includes a 4-level race variable. Equations were developed in pooled data from 10 studies (N=8254) and validated in 17 additional studies from the US and Europe [CKD-EPI validation database (N=4014)], and in studies from China (N=675), Japan (N=248) and South Africa (N=99). Race was defined as a 2-level variable (Black vs other) and a 4-level variable (Black, Asian, Native American and Hispanic vs other). Coefficients for Black, Asian and Native American and Hispanic resulted in 15%, 5% and 1% higherlevels of estimated GFR, respectively, compared to others. The 2-level race equation had minimal bias in Blacks, Native Americans, Hispanics and others [−0.8 (−2.0,0.6), 2.3 (−2.1,5.1), and 2.8 (2.4,3.2) ml/min/1.73 m2, respectively) in the CKD-EPI validation database. The 4-level race equation improved bias in CKD-EPI Asians (0.8 (−2.2,2.6) vs 2.1 (0.3,4.4) ml/min/1.73 m2) and in Chinese (1.3 (0.6,2.2) vs 2.7 (1.9,3.7) ml/min/1.73 m2). Both equations had a large bias in Japanese [−17.8 (−0.1,−14.7) and −21.4 (−23.2,−18.2) ml/min/1.73 m2)] and South Africans [−12.4 (−18.3,−7.6) and −12.5 (−18.3,−7.6) ml/min/1.73 m2. A multilevel variable for race developed in one geographic region may not be applicable in other regions. The 2-level race variable in the CKD-EPI equation can be used for all racial-ethnic groups in the US and Europe.