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老年个体中两种不同公式估算的肾小球滤过率的差异。

Difference in estimated GFR with two different formulas in elderly individuals.

作者信息

Wieczorowska-Tobis K, Niemir Z I, Guzik P, Breborowicz A, Oreopoulos D G

机构信息

Department of Pathophysiology, University of Medical Sciences, 60-781, Poznan, Poland.

出版信息

Int Urol Nephrol. 2006;38(2):381-5. doi: 10.1007/s11255-006-0065-7.

Abstract

The aim of this study was to characterize the differences between the prediction of GFR with Cockcroft-Gault formula (CG=(140-age)/(72 x PCr (mg/ml), for females multiplied by 0.85) and the new formula based on the multicenter trial of the Modification of Diet in Renal Diseases (MDRD=186 x P (Cr) (-1.154) x age(-0.203); 0.742 if patient is female) in elderly subjects. The study involved 100 individuals aged 65-111 years (mean age 88.3+/-14.7; 79 females and 21 males). In all subjects GFR was estimated according to both formulas mentioned above and expressed in ml/min/1.73 m2. Thereafter we calculated the difference between MDRD and CG (MDRD-CG) and analyzed its determinants in every subject. Mean GFR, obtained with MDRD was 76.0+/-24.0, whereas according to CG 67.9+/-18.6 (p < 0.0001). However, the mean MDRD-CG was up to 30.0+/-26.6 which means that MDRD results were much higher in comparison with CG. Using the multiple linear regression analysis we showed that MDRD-CG strongly depend on age (p < 0.0001), BMI (p < 0.0001) and serum creatinine concentration (p<0.0001). However, the gender has not effect on MDRD-CG value. The values of MDRD-CG strongly and positively correlated with age (r=0.7027, p < 0.0001) and negatively both with body mass index (r=-0.7171, p < 0.0001) and serum creatinine (r=-0.5590, p < 0.0001). In summary, our results show that the difference between MDRD and CG strongly depends on age, BMI and Scr. Investigators should be aware of these differences and take it into account in elderly.

摘要

本研究的目的是描述在老年受试者中,用Cockcroft-Gault公式(CG =(140 - 年龄)/(72×血肌酐(毫克/毫升),女性乘以0.85)预测肾小球滤过率(GFR)与基于肾脏疾病饮食改良多中心试验的新公式(MDRD = 186×血肌酐(-1.154)×年龄(-0.203);如果患者为女性则为0.742)之间的差异。该研究纳入了100名年龄在65 - 111岁之间的个体(平均年龄88.3±14.7岁;79名女性和21名男性)。在所有受试者中,根据上述两种公式估算GFR,并以毫升/分钟/1.73平方米表示。此后,我们计算了MDRD与CG之间的差值(MDRD - CG),并分析了每个受试者中该差值的决定因素。用MDRD得出的平均GFR为76.0±24.0,而根据CG得出的为67.9±18.6(p < 0.0001)。然而,平均MDRD - CG高达30.0±26.6,这意味着与CG相比,MDRD的结果要高得多。通过多元线性回归分析,我们发现MDRD - CG强烈依赖于年龄(p < 0.0001)、体重指数(p < 0.0001)和血清肌酐浓度(p < 0.0001)。然而,性别对MDRD - CG值没有影响。MDRD - CG值与年龄呈强正相关(r = 0.7027,p < 0.0001),与体重指数(r = -0.7171,p < 0.0001)和血清肌酐(r = -0.5590,p < 0.0001)均呈负相关。总之,我们的结果表明,MDRD与CG之间的差异强烈依赖于年龄、体重指数和血肌酐。研究人员应意识到这些差异,并在老年人群中予以考虑。

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