A more accurate method acquirement by a comparison of the prediction equations for estimating glomerular filtration rate in Chinese patients with obstructive nephropathy.
A more accurate method acquirement by a comparison of the prediction equations for estimating glomerular filtration rate in Chinese patients with obstructive nephropathy.
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通过比较中国梗阻性肾病患者肾小球滤过率预测方程的比较获得更准确的方法
DOI：
10.1186/s12882-016-0345-0
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发表时间：
2016-10-18
期刊：
影响因子：
2.3
通讯作者：
Han M
中科院分区：
文献类型：
--
作者：
Chen M;Xia J;Pei G;Zhang Y;Wu S;Qin Y;Deng Y;Guo S;Guo Y;Xu G;Han M
研究背景研究人员已经开发了几个方程来预测慢性肾脏疾病（CKD）患者的肾小球滤过率（GFR）。然而，几乎没有任何研究进行辨别的最佳方程，以估计GFR的患者与纯粹的梗阻性肾病。在本研究中，我们评估了六个预测方程的适用性，并比较其性能在eGFR评估为中国patientswithobstructionnephropathy.MethodsA共245例成人梗阻性肾病患者。我们评估了3种肾脏疾病饮食改良公式（MDRD）的性能（原始MDRD 7，7 MDRD;缩写MDRD，aMDRD;和重新表达的缩写MDRD，re-aMDRD）和3个慢性肾脏病流行病学协作组方程（CKD-EPI）（CKD-EPI方程仅基于肌酐，CKD-EPIcr; CKD-EPI方程仅基于胱抑素C，CKD-EPIcys; CKD-EPI方程基于肌酸-半胱氨酸蛋白酶抑制剂组合，CKD-EPIcr-cys）。结果研究人群平均年龄为51.61 ± 14.17岁，男性131例（53.47%）。平均GFR测量值为66.54 ± 23.99 ml/min/1.73 m2。总体而言，CKD-EPIcr-cys方程具有最佳相关性（R= 0.72）和一致性（-34.87，40.83）。CKD-EPIcr-cys方程诊断准确率最高（69.39%，P< 0.01），诊断效能最高（ROCAUC= 0.874），偏倚最小（2.98，P < 0.01）。在GFR最低的亚组中，CKD-EPIcys方程的准确性最高（52.69%），偏倚最小（0.27）。在最年轻年龄组中，CKD-EPIcys方程的准确性最高（71.64%），偏倚最小（-1.24）。结论3个CKD-EPI方程在估算中国梗阻性肾病患者GFR方面优于3个MDRD方程;而基于肌酐-胱抑素C联合的CKD-EPI方程可提供最佳的GFR估算值。
BackgroundResearchers have developed several equations to predict glomerular filtration rate (GFR) in patients with chronic kidney diseases (CKD). However, there are scarcely any studies performed to discern the best equation to estimate GFR in patients with pure obstructive nephropathy. In present study, we assessed the suitability of six prediction equations and compared their performance in eGFR evaluation for Chinese patients with obstructive nephropathy.MethodsA total of 245 adult patients with obstructive nephropathy were enrolled. We evaluated the performance of the 3 Modification of Diet in Renal Disease equations (MDRD) (the original MDRD7, 7MDRD; the abbreviated MDRD, aMDRD; and re-expressed abbreviated MDRD, re-aMDRD) and 3 Chronic Kidney Disease Epidemiology Collaboration equations (CKD-EPI) (CKD-EPI equation based on creatinine alone, CKD-EPIcr; CKD-EPI equation based on cystatin C alone, CKD-EPIcys; CKD-EPI equation based on combined creatinine-cystatin, CKD-EPIcr-cys). The measured GFR (mGFR) by99mTc-DTPA renal dynamic imaging method was used as the reference GFR.ResultsThe mean age of the study population was 51.61 ± 14.17 and 131 were male (53.47 %). The mean measured GFR was 66.54 ± 23.99 ml/min/1.73 m2. Overall, the CKD-EPIcr-cys equation gave the best performance with the best correlation (R= 0.72) and agreement (−34.87, 40.83). CKD-EPIcr-cys equation also exhibited the highest accuracy (69.39 %,P< 0.01) and diagnostic efficacy (ROCAUC= 0.874) with the smallest bias (2.98,P< 0.01). In the subgroup of the lowest GFR, CKD-EPIcys equation exhibited the highest accuracy (52.69 %) and the smallest bias (0.27). In the youngest age subgroup, CKD-EPIcys equation had the highest accuracy (71.64 %) and the smallest bias (−1.24). In other subgroups stratified by GFR, age and gender, CKD-EPIcr-cys equation remained the best performance.ConclusionThe 3 CKD-EPI equations performed better than the 3 MDRD equations in estimating GFR in Chinese obstructive nephropathy patients; while the CKD-EPI equation based on combined creatinine-cystatin C provided the best estimation of GFR.
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DOI：
10.1056/nejmoa1114248
发表时间：
2012-07-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Inker LA;Schmid CH;Tighiouart H;Eckfeldt JH;Feldman HI;Greene T;Kusek JW;Manzi J;Van Lente F;Zhang YL;Coresh J;Levey AS;CKD-EPI Investigators
通讯作者：
CKD-EPI Investigators
DOI：
10.2215/cjn.06870909
发表时间：
2010-06-01
影响因子：
9.8
作者：
Michels, Wieneke Marleen;Grootendorst, Diana Carina;Krediet, Raymond Theodorus
通讯作者：
Krediet, Raymond Theodorus
影响因子：
39.2
作者：
Levey, Andrew S.;Coresh, Josef;Van Lente, Frederick
通讯作者：
Van Lente, Frederick
影响因子：
5.9
作者：
Stevens, LA;Levey, AS
通讯作者：
Levey, AS
影响因子：
19.6
作者：
Stevens LA;Schmid CH;Greene T;Li L;Beck GJ;Joffe MM;Froissart M;Kusek JW;Zhang YL;Coresh J;Levey AS
通讯作者：
Levey AS