运用肾病饮食改良公式和Cockcroft-Gault公式估算南非黑人的肾小球滤过率。
Estimating glomerular filtration rate in black South Africans by use of the modification of diet in renal disease and Cockcroft-Gault equations.
作者信息
van Deventer Hendrick E, George Jaya A, Paiker Janice E, Becker Piet J, Katz Ivor J
机构信息
Department of Chemical Pathology and NHLS, University of the Witwatersrand, Johannesburg, South Africa.
出版信息
Clin Chem. 2008 Jul;54(7):1197-202. doi: 10.1373/clinchem.2007.099085. Epub 2008 May 16.
BACKGROUND
The 4-variable Modification of Diet in Renal Disease (4-v MDRD) and Cockcroft-Gault (CG) equations are commonly used for estimating glomerular filtration rate (GFR); however, neither of these equations has been validated in an indigenous African population. The aim of this study was to evaluate the performance of the 4-v MDRD and CG equations for estimating GFR in black South Africans against measured GFR and to assess the appropriateness for the local population of the ethnicity factor established for African Americans in the 4-v MDRD equation.
METHODS
We enrolled 100 patients in the study. The plasma clearance of chromium-51-EDTA ((51)Cr-EDTA) was used to measure GFR, and serum creatinine was measured using an isotope dilution mass spectrometry (IDMS) traceable assay. We estimated GFR using both the reexpressed 4-v MDRD and CG equations and compared it to measured GFR using 4 modalities: correlation coefficient, weighted Deming regression analysis, percentage bias, and proportion of estimated GFR within 30% of measured GFR (P(30)).
RESULTS
The Spearman correlation coefficient between measured and estimated GFR for both equations was similar (4-v MDRD R(2) = 0.80 and CG R(2) = 0.79). Using the 4-v MDRD equation with the ethnicity factor of 1.212 as established for African Americans resulted in a median positive bias of 13.1 (95% CI 5.5 to 18.3) mL/min/1.73 m(2). Without the ethnicity factor, median bias was 1.9 (95% CI -0.8 to 4.5) mL/min/1.73 m(2).
CONCLUSIONS
The 4-v MDRD equation, without the ethnicity factor of 1.212, can be used for estimating GFR in black South Africans.
背景
肾脏病饮食改良4变量（4-v MDRD）方程和Cockcroft-Gault（CG）方程常用于估算肾小球滤过率（GFR）；然而，这两个方程均未在非洲本土人群中得到验证。本研究的目的是评估4-v MDRD方程和CG方程在估算南非黑人GFR方面相对于实测GFR的性能，并评估4-v MDRD方程中为非裔美国人设定的种族因素对当地人群的适用性。
方法
我们招募了100名患者参与本研究。采用铬-51-乙二胺四乙酸（(51)Cr-EDTA）血浆清除率来测量GFR，并使用同位素稀释质谱（IDMS）溯源检测法测量血清肌酐。我们使用重新表达的4-v MDRD方程和CG方程估算GFR，并通过4种方式将其与实测GFR进行比较：相关系数、加权Deming回归分析、百分比偏差以及估算GFR在实测GFR的30%范围内的比例（P(30)）。
结果
两个方程的实测GFR与估算GFR之间的Spearman相关系数相似（4-v MDRD方程R(2)=0.80，CG方程R(2)=0.79）。使用为非裔美国人设定的种族因素1.212的4-v MDRD方程时，中位数正偏差为13.1（95%CI 5.5至18.3）mL/min/1.73 m(2)。不使用种族因素时，中位数偏差为1.9（95%CI -0.8至4.5）mL/min/1.73 m(2)。
结论
不使用1.212种族因素的4-v MDRD方程可用于估算南非黑人的GFR。
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