Estimating GFR Among Participants in the Chronic Renal Insufficiency Cohort (CRIC) Study
Estimating GFR Among Participants in the Chronic Renal Insufficiency Cohort (CRIC) Study
复制标题
DOI：
10.1053/j.ajkd.2012.04.012
复制
发表时间：
2012-08-01
影响因子：
13.2
通讯作者：
Feldman, Harold I.
中科院分区：
文献类型：
--
作者：
Anderson, Amanda Hyre;Yang, Wei;Feldman, Harold I.
背景：肾小球滤过率(GFR)被认为是衡量肾功能的最佳指标，但在大多数研究中重复评估是不可行的。研究设计：对慢性肾功能不全队列(CRIC)研究(即GFR亚队列)的1,433名参与者进行横断面研究，采用分裂样本法推导出内部GFR估计方程。地点和对象：来自美国7个大都市地区的患有轻度至中度慢性肾脏疾病的成年人；指数测试：CRIC GFR估计方程。参考测试或结果：尿碘-125-硫代巴比妥酸清除测试(测量的GFR[mGFR])。其他测量：实验室测量，包括血肌酐和胱抑素C，以及人体测量学。结果：在验证数据集中，与另外包括生物阻抗分析相角、CRIC临床中心和24小时尿肌酸排泄的模型相比，包括血肌酐水平、血清胱抑素C水平、年龄、性别和种族的模型对mGFR的预测最简明和相似。具体而言，两个独立模型的均方根误差分别为0.207和0.202。CRIC GFR估计方程在年轻参与者、男性、非黑人、非西班牙裔、没有糖尿病的人和有体重指数的人的亚组中表现最准确
Background: Glomerular filtration rate (GFR) is considered the best measure of kidney function, but repeated assessment is not feasible in most research studies.Study Design: Cross-sectional study of 1,433 participants in the Chronic Renal Insufficiency Cohort (CRIC) Study (ie, the GFR subcohort) to derive an internal GFR estimating equation using a split-sample approach.Setting & Participants: Adults from 7 US metropolitan areas with mild to moderate chronic kidney disease; 48% had diabetes and 37% were black.Index Test: CRIC GFR estimating equation.Reference Test or Outcome: Urinary I-125-iothalamate clearance testing (measured GFR [mGFR]).Other Measurements: Laboratory measures, including serum creatinine and cystatin C, and anthropometrics.Results: In the validation data set, the model that included serum creatinine level, serum cystatin Clevel, age, sex, and race was the most parsimonious and similarly predictive of mGFR compared with a model additionally including bioelectrical impedance analysis phase angle, CRIC clinical center, and 24-hour urinary creatinine excretion. Specifically, root mean square errors for the separate models were 0.207 versus 0.202, respectively. Performance of the CRIC GFR estimating equation was most accurate for the subgroups of younger participants, men, nonblacks, non-Hispanics, those without diabetes, those with body mass index