Rigalleau Vincent, Lasseur Catherine, Raffaitin Christelle, Perlemoine Caroline, Barthe Nicole, Chauveau Philippe, Combe Christian, Gin Henri
Université de Bordeaux 2--Victor Segalen, 33000 Bordeaux, France.
Nephrol Dial Transplant. 2007 Mar;22(3):813-8. doi: 10.1093/ndt/gfl649. Epub 2006 Nov 24.
Although recommended, both the Cockcroft and Gault formula (CG) and the modification of diet in renal disease (MDRD) equation are not ideally predictive of glomerular filtration rate (GFR) in diabetic subjects; we tested whether the new Mayo Clinic Quadratic (MCQ) equation performed better.
In 200 diabetic subjects with a wide range of renal function, GFR was measured by 51Cr-EDTA clearance, and compared with the results of the three predictive equations by regression analysis and Bland and Altman procedures. The correlations with body mass index, age and albumin excretion rates were tested. The precisions (absolute difference as percentage), diagnostic accuracies [receiver operating characteristic (ROC) curves for the diagnosis of moderate and severe chronic kidney disease (CKD)], and the results of stratification according to the KDOQ classification were compared.
The CG and MCQ overestimated mean GFR, whereas the MDRD underestimated it. Correlation coefficients and areas under the ROC curves were better for the MDRD and the MCQ as compared with the CG, which was biased by body weight (+30% overestimation in obese diabetic subjects). The absolute differences with true GFR were slightly lower for the MDRD than the MCQ, and both better than the CG. Both the MDRD and MCQ correctly stratified 65% of the subjects (CG: 55%, P<0.05). In contrast with the MDRD, the MCQ did not underestimate normal GFR, and its performance for stratification was uniformly good over a wide GFR range.
In diabetic subjects, the MCQ has a similar diagnostic performance to the MDRD, but it does not underestimate normal GFR, which is an important advantage.
尽管有推荐，但考克饶夫-高尔特公式（CG）和肾病饮食改良（MDRD）方程对糖尿病患者肾小球滤过率（GFR）的预测都不理想；我们测试了新的梅奥诊所二次方程（MCQ）是否表现更好。
在200名肾功能范围广泛的糖尿病患者中，通过51Cr-EDTA清除率测量GFR，并通过回归分析以及布兰德和奥特曼方法与三个预测方程的结果进行比较。测试了与体重指数、年龄和白蛋白排泄率的相关性。比较了精确度（绝对差异百分比）、诊断准确性[用于诊断中度和重度慢性肾脏病（CKD）的受试者工作特征（ROC）曲线]以及根据肾脏疾病饮食改良（KDOQ）分类的分层结果。
CG和MCQ高估了平均GFR，而MDRD低估了它。与受体重影响（肥胖糖尿病患者高估30%）的CG相比，MDRD和MCQ的相关系数以及ROC曲线下面积更好。MDRD与真实GFR的绝对差异略低于MCQ，两者都优于CG。MDRD和MCQ都正确地对65%的受试者进行了分层（CG：55%，P<0.05）。与MDRD不同，MCQ没有低估正常GFR，并且其在广泛的GFR范围内分层表现均良好。
在糖尿病患者中，MCQ与MDRD具有相似的诊断性能，但它不会低估正常GFR，这是一个重要优势。
