Assessing glomerular filtration rate by estimation equations in kidney transplant recipients
Assessing glomerular filtration rate by estimation equations in kidney transplant recipients
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DOI：
10.1111/j.1600-6143.2005.01140.x
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发表时间：
2006-01-01
影响因子：
8.8
通讯作者：
Hall, R
中科院分区：
文献类型：
--
作者：
Poggio, ED;Wang, X;Hall, R
肾小球滤过率（GFR）的监测对于肾移植受者的管理至关重要。我们特别强调血清肌酐 (SCr) 校准测定，我们使用肾病饮食调整 (MDRD)、Nankivell 和 Cockcroft-Gault 方法评估了 209 名患者的估计方程与碘酞酸 GFR (iGFR) 的性能。 55% 的患者接受了钙调神经磷酸酶抑制剂 (CNI) 治疗，并且在 SCr 测量时均服用了甲氧苄啶-磺胺甲恶唑。平均 iGFR 为 44±26 mL/min/1.73 m(2)。 MDRD 方程显示中位差异为 0.9 mL/min/1.73 m(2)，其中 53% 的估计 GFR 在 iGFR 的 20% 范围内。 Nankivell 和 Cockcroft-Gault 公式的中位差异分别为 7.5 和 7.0 mL/min/1.73 m(2)。 Nankivell 和 Cockcroft-Gault 公式的准确性非常高，分别只有 38% 和 37% 的估计值落在 iGFR 的 20% 以内。所有方程的性能在整个 GFR 范围内并不统一，在 GFR 水平的极端情况下会出现一些恶化。此外，在服用 CNI 的受试者中，MDRD 方程表现良好。总之，在肾移植受者（包括接受 CNI 治疗的受试者）中，MDRD 方程的整体性能优于 Nankivell 和 Cockcroft-Gault 公式。
Surveillance of glomerular filtration rate (GFR) is crucial in the management of kidney transplant recipients. With especial emphasis on serum creatinine (SCr) calibration assay, we assessed the performance of estimation equations as compared to iothalamate GFR (iGFR) in 209 patients using the modification of diet in renal disease (MDRD), Nankivell and Cockcroft-Gault methods. Fifty-five percent of patients were treated with a calcineurin inhibitor (CNI) and all were taken trimethroprim-sulfametoxazole at the time of SCr measurement. The mean iGFR was 44 26 mL/min/1.73 m(2). The MDRD equation showed a median difference of 0.9 mL/min/1.73 m(2) with 53% of estimated GFR within 20% of iGFR. Median differences were 7.5 and 7.0 mL/min/1.73 m(2) for Nankivell and Cockcroft-Gault formulas, respectively. The accuracy of the Nankivell and Cockcroft-Gault formulas was such that only 38% and 37% of estimations, respectively, fell within 20% of iGFR. The performance of all equations was not uniform throughout the whole range of GFR, with some deterioration at the extremes of GFR levels. In addition, good performance of the MDRD equation was seen in subjects taking CNI. In conclusion, the overall performance of the MDRD equation was superior to the Nankivell and Cockcroft-Gault formulas in renal transplant recipients including subjects treated with CNI.