对于晚期慢性肾衰竭患者，Cockcroft-Gault方程在估算肾小球滤过率方面优于MDRD方程。

[The Cockcroft-Gault equation is better than MDRD equation to estimate the glomerular filtration rate in patients with advanced chronic renal failure].

作者信息

Teruel J L, Sabater J, Galeano C, Rivera M, Merino J L, Fernández Lucas M, Marcén R, Ortuño J

机构信息

Servicio de Nefrología, Hospital Ramón y Cajal, Madrid, Spain.

出版信息

Nefrologia. 2007;27(3):313-9.

PMID:17725450

Abstract

ABSTRACT The aim of this study was to compare the accuracy of three kidney function estimating equations: classic Cockcroft-Gault (classic CG), corrected Cockcroft-Gault (corrected CG) and simplified Modification of Diet in Renal Disease (MDRD), in patients with advanced chronic renal failure. The study was made in 84 nondialyzed patients with chronic renal disease in stage 4 or 5. The glomerular filtration rate was measured on a 24-hour urine collection as the arithmetic mean of the urea and creatinine clearances (CUrCr). In each patient, the difference between each estimating equation and the measured glomerular filtration rate was calculated. The absolute difference expressed as a percentage of the measured glomerular filtration rate indicates the intermethod variability. In the total group the glomerular filtration rate measured as the CUrCr was de 13,5+/-5,1 ml/min/1.73 m(2); and the results of the estimating equations were: classic CG 14,2+/-5 (p<0,05); corrected CG 12+/-4,2 (p<0,01) and MDRD : 12,1+/-4,8 ml/min/1.73 m(2) (p<0,01). The variability of the estimating equations was 15,2+/-12,2%, 17,1+/-13,4 % and 19,3+/-13,3% (p<0,05), for classic CG, corrected CG and MDRD respectively. The percent of estimates falling within 30% above o below the measured glomerular filtration rate was 90% for CG classic, 87% for corrected CG and 79% for MDRD. The intraclass correlation coefficients respect to CUrCr were 0,86 for classic CG, 0,81 for corrected CG and 0,77 for MDRD. The MDRD variability, but not classic CG variability or corrected CG variability, showed a positive correlation with the glomerular filtration rate (r=0,25, p<0,05). In patients with chronic renal disease in stage 5, the variability of the different estimating equations was similar. We conclude that in our population with advanced chronic renal failure the classic CG equation is more accurate than the MDRD equation. Corrected CG equation has not any advantage respect to classic CG equation.

摘要

摘要本研究旨在比较经典Cockcroft - Gault公式（经典CG）、校正后的Cockcroft - Gault公式（校正CG）和简化的肾脏病饮食改良公式（MDRD）在晚期慢性肾衰竭患者中估算肾功能的准确性。该研究纳入了84例处于4期或5期的未接受透析治疗的慢性肾病患者。通过收集24小时尿液，以尿素清除率和肌酐清除率（CUrCr）的算术平均值来测定肾小球滤过率。计算每位患者每个估算公式与测量的肾小球滤过率之间的差值。以测量的肾小球滤过率的百分比表示的绝对差值表明了不同方法间的变异性。在整个研究组中，以CUrCr测量的肾小球滤过率为13.5±5.1 ml/min/1.73 m²；估算公式的结果分别为：经典CG 14.2±5（p<0.05）；校正CG 12±4.2（p<0.01）以及MDRD：12.1±4.8 ml/min/1.73 m²（p<0.01）。经典CG、校正CG和MDRD估算公式的变异性分别为15.2±12.2%、17.1±13.4%和19.3±13.3%（p<0.05）。落在测量的肾小球滤过率上下30%范围内的估算值百分比，经典CG为90%，校正CG为87%，MDRD为79%。相对于CUrCr的组内相关系数，经典CG为0.86，校正CG为0.81，MDRD为0.77。MDRD的变异性与肾小球滤过率呈正相关（r = 0.25，p<0.05），而经典CG和校正CG的变异性则不然。在5期慢性肾病患者中，不同估算公式的变异性相似。我们得出结论，在我们的晚期慢性肾衰竭人群中，经典CG公式比MDRD公式更准确。校正CG公式相对于经典CG公式没有任何优势。