Difference between CKD-EPI and MDRD equations in calculating glomerular filtration rate in patients with cirrhosis

Difference between CKD-EPI and MDRD equations in calculating glomerular filtration rate in patients with cirrhosis
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DOI:
10.3748/wjg.v17.i40.4532
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发表时间:
2011-10-28
影响因子:
4.3
通讯作者:
Wu, Chih-Jen
Wu, Chih-Jen
中科院分区:
医学2区
文献类型:
--
作者:
Chen, Yu-Wei;Chen, Han-Hsiang;Wu, Chih-Jen

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目的:评价肝硬化患者CKD-EPI和饮食调整在肾病(MDRD)方程中的差异。方法:2004年1月至2008年10月,对4127例肝硬化患者进行回顾性分析。排除肾功能资料不完整的患者;因此,共有3791例患者被纳入研究。肾小球滤过率(GFR)由4变量MDRD (MDRD-4)、6变量MDRD (MDRD-6)和CKD-EPI方程估算。结果:当男性和女性血清肌酐分别为0.7-6.8 mg/dL和0.6-5.3 mg/dL时,MDRD-6估计的GFR明显低于CKD-EPI。当男性和女性的肌酐分别为> 6.9 mg/dL和> 5.4 mg/dL时,用这两个方程计算出相似的gfr。在预测院内死亡率方面,MDRD-6获得的估测GFR准确率更高[81.72%;95%可信区间(CI), 0.94-0.95]高于MDRD-4 (80.22%, 95% CI, 0.96-0.97)、CKD-EPI (79.93%, 95% CI, 0.96-0.96)和肌酐(77.50%,95% CI, 2.27-2.63)。结论:6变量MDRD方程计算的GFR可能比CKD-EPI方程计算的GFR更接近真实GFR。(C) 2011年白石登。版权所有。
AIM: To evaluate the difference between the performance of the (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations in cirrhotic patients.METHODS: From Jan 2004 to Oct 2008, 4127 cirrhotic patients were reviewed. Patients with incomplete data with respect to renal function were excluded; thus, a total of 3791 patients were included in the study. The glomerular filtration rate (GFR) was estimated by the 4-variable MDRD (MDRD-4), 6-variable MDRD (MDRD-6), and CKD-EPI equations.RESULTS: When serum creatinine was 0.7-6.8 mg/dL and 0.6-5.3 mg/dL in men and women, respectively, a significantly lower GFR was estimated by the MDRD-6 than by the CKD-EPI. Similar GFRs were calculated by both equations when creatinine was > 6.9 mg/dL and > 5.4 mg/dL in men and women, respectively. In predicting in-hospital mortality, estimated GFR obtained by the MDRD-6 showed better accuracy [81.72%; 95% confidence interval (CI), 0.94-0.95] than that obtained by the MDRD-4 (80.22%; 95% CI, 0.96-0.97), CKD-EPI (79.93%; 95% CI, 0.96-0.96), and creatinine (77.50%; 95% CI, 2.27-2.63).CONCLUSION: GFR calculated by the 6-variable MDRD equation may be closer to the true GFR than that calculated by the CKD-EPI equation. (C) 2011 Baishideng. All rights reserved.