Limitations of estimating glomerular filtration rate from serum creatinine in the general population
Limitations of estimating glomerular filtration rate from serum creatinine in the general population
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DOI：
10.4065/81.11.1427
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发表时间：
2006-11-01
影响因子：
8.9
通讯作者：
Jacobsen, Steven J.
中科院分区：
文献类型：
--
作者：
Rule, Andrew D.;Rodeheffer, Richard J.;Jacobsen, Steven J.
OBJECTIVE: To compare estimated glomerular filtration rate (GFR) in the general population on the basis of equations derived from different subsets of the general population.PARTICIPANTS AND METHODS: Adults (ages >= 45 years) were randomly selected from 1997 to 2000 from the Olmsted County, Minnesota, population and had their serum creatinine levels measured. The GFR was estimated using previously reported equations derived from a sample of patients with chronic kidney disease (CKD), a sample of healthy persons, and the combined samples. Serum creatinine was measured with the same assay used to derive these equations.RESULTS: Of 4203 subjects, 2042 (47% participation rate) were enrolled and studied. Serum samples from 1982 subjects were used to measure creatinine levels. The prevalence of a reduced estimated GFR (< 60 mIL/min per 1.73 m(2)) was 12% (95% confidence interval [CI], 10%-13%) based on an equation derived with all CKD patients, and this finding was similar to prior reports. However, the prevalence of a reduced estimated GFR was 5.7% (95% CI, 4.8%-6.8%) based on an equation derived with both CKD patients and healthy persons and 0.2% (95% CI, 0.1%-0.5%) based on an equation derived with all healthy persons. Women had a higher risk of reduced estimated GFR according to an equation derived with all CKD patients, but men had a higher risk with an equation derived with both CKD patients and healthy persons.CONCLUSION: The use of serum creatinine to diagnose CKD requires a different approach (eg, normal value study) from the use of serum creatinine to estimate GFR once the diagnosis of CKD has been made.
