Differences in estimation of creatinine generation between renal function estimating equations in an Indian population: cross-sectional data from the Hyderabad arm of the Indian migration study
Differences in estimation of creatinine generation between renal function estimating equations in an Indian population: cross-sectional data from the Hyderabad arm of the Indian migration study
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DOI：
10.1186/1471-2369-14-30
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发表时间：
2013-02-04
期刊：
影响因子：
2.3
通讯作者：
Ben-Shlomo, Yoav
中科院分区：
文献类型：
--
作者：
Bailey, Phillippa K.;Tomson, Charles R. V.;Ben-Shlomo, Yoav
背景：在白人群体中开发的基于肌酐的肾功能估算公式在其他种族群体中可能不太有效。我们评估了各种估计公式在印度人口中的表现。方法：从印度移民研究的海得拉巴部门招募了 917 名受试者。通过 DXA 扫描收集有关合并症、血清肌酐和身体成分的数据。使用改良的 Cockcroft Gault、MDRD 和 CKD EPI 公式比较肾功能。 24 小时肌酐产量源自每次估计以及与所检查的测量肌肉质量的一致性。将 24 小时肌酐产量估计值与通过规则结合 DXA 测量的肌肉质量得出的公式进行比较。通过年龄和 eGFR 检查潜在的系统偏差。我们评估了每个公式的肾功能与高血压和血管疾病自我报告测量值的关联。结果：平均改良 Cockcroft-Gault eCCl 为 98.8 ml/min/1.73 m(2)，MDRD eGFR 91.2 ml/min/1.73 m(2) 和 CKD-EPI eGFR 96.3ml/min/1.73 m(2)。与规则公式相比，MDRD 得出的 24 小时肌酐生成量与年龄相关的低估程度最小。 CKD-EPI 在 eGFR 较高时表现出明显的偏差。所有公式都显示出与血管疾病和高血压相似的强度关联。结论：我们的分析支持使用 MDRD 来评估印度人群的肾功能。需要进一步的工作来评估公式对 CKD 疾病和并发症的预测价值。
Background: Creatinine based formulae for estimating renal function developed in white populations may be less valid in other ethnic groups. We assessed the performance of various estimating formulae in an Indian population.Methods: 917 subjects were recruited from the Hyderabad arm of the Indian Migration Study. Data were collected on comorbidity, serum creatinine and body composition from DXA scans. Renal function was compared using the modified Cockcroft Gault, MDRD and CKD EPI formulae. 24 hour creatinine production was derived from each estimate and the agreement with measured muscle mass examined. 24 hour creatinine production estimates were compared to that derived from a formula by Rule incorporating DXA measured muscle mass. Potential systematic biases were examined by age and eGFR. We assessed the association of renal function by each formula with hypertension and self-reported measures of vascular disease.Results: Mean modified Cockcroft-Gault eCCl was 98.8 ml/min/1.73 m(2), MDRD eGFR 91.2 ml/min/1.73 m(2) and CKD-EPI eGFR 96.3ml/min/1.73 m(2). MDRD derived 24-hour creatinine production showed the least age-related underestimation compared to the Rule formula. CKD-EPI showed a marked bias at higher eGFRs. All formulae showed similar strength associations with vascular disease and hypertension.Conclusions: Our analyses support the use of MDRD for estimating renal function in Indian populations. Further work is required to assess the predictive value of formulae for incident disease and complications of CKD.