The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation is less accurate in patients with Type 2 diabetes when compared with healthy individuals
The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation is less accurate in patients with Type 2 diabetes when compared with healthy individuals
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DOI：
10.1111/j.1464-5491.2010.03161.x
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发表时间：
2011-01-01
影响因子：
3.5
通讯作者：
Silveiro, S. P.
中科院分区：
文献类型：
--
作者：
Camargo, E. G.;Soares, A. A.;Silveiro, S. P.
目的分析慢性肾脏病流行病学协作（CKD-EPI）和肾脏疾病饮食调整（MDRD）研究方程对肾小球滤过率（GFR）在GFR为60 ml/min的2型糖尿病患者和健康志愿者中的表现。方法横断面研究纳入111例个体（56例2型糖尿病患者和55例健康志愿者），年龄58±9岁；男性54人（49%），白人98人（88%）。采用51Cr-EDTA单次注射法（51Cr-GFR）测定肾小球滤过率，并根据标准化MDRD和CKD-EPI方程进行估算。采用可溯源Jaffe法测定血清肌酐。Bland-Altman分析用于检验GFR测量值与估计值之间的一致性。评估偏倚、准确度和精密度。结果糖尿病患者51Cr-GFR为106 +/- 27 ml/min/1.73 m2， ckd - epi估计GFR为82 +/- 18 ml/min/1.73 m2， mdrd估计GFR为80 +/- 21 ml/min/1.73 m2 （P < 0.001）。健康志愿者的相应值分别为98 +/- 20、89 +/- 13和84 +/- 14 ml/min/1.73 m2 （P < 0.001）。健康志愿者CKD-EPI （P30）的准确性高于糖尿病患者（分别为90%和66%，P < 0.001）。在2型糖尿病患者中，MDRD方程的表现与CKD-EPI方程一样差。结论：与健康个体相比，2型糖尿病患者的CKD-EPI方程准确性较低，偏差增加2.5倍。
P>AimsTo analyse the performances of Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and of Modification of Diet in Renal Disease (MDRD) study equations to estimate glomerular filtration rate (GFR) in patients with Type 2 diabetes mellitus with GFRs > 60 ml/min and in healthy volunteers.MethodsThis cross-sectional study included 111 individuals (56 patients with Type 2 diabetes and 55 healthy volunteers), aged 58 +/- 9 years; 54 individuals were men (49%) and ninety-eight (88%) were white. Glomerular filtration rate was measured by the 51Cr-EDTA single-injection method (51Cr-GFR) and estimated according to the standardized MDRD and CKD-EPI equations. Serum creatinine was measured by a traceable Jaffe method. Bland-Altman analysis was used to examine the agreement between measured and estimated GFR. Bias, accuracy and precision were evaluated.ResultsIn diabetic individuals, 51Cr-GFR was 106 +/- 27 ml/min/1.73 m2, CKD-EPI-estimated GFR 82 +/- 18 ml/min/1.73 m2 and MDRD-estimated GFR 80 +/- 21 ml/min/1.73 m2 (P < 0.001). In healthy volunteers, the corresponding values were 98 +/- 20, 89 +/- 13 and 84 +/- 14 ml/min/1.73 m2 (P < 0.001). The accuracy of CKD-EPI (P30) was higher in healthy volunteers than in diabetic patients (90 vs. 66%, respectively, P < 0.001). The MDRD equation performed as poorly as the CKD-EPI equation in individuals with Type 2 diabetes.ConclusionsThe CKD-EPI equation is less accurate in patients with Type 2 diabetes when compared with healthy individuals, with a 2.5-fold greater bias.