Agaba Emmanuel I, Wigwe Chinyere M, Agaba Patricia A, Tzamaloukas Antonios H
Department of Medicine, Nephrology Division, Jos University Teaching Hospital, Plateau State, Nigeria.
Int Urol Nephrol. 2009;41(3):635-42. doi: 10.1007/s11255-008-9515-8. Epub 2009 Jan 10.
Estimation of the glomerular filtration rate (GFR) is required in the assessment of patients with chronic kidney disease (CKD) in order to provide information regarding the functional status of the kidneys. Current guidelines advocate the use of prediction equations, such as the Cockcroft-Gault (CG) formula and the Modification of Diet in Renal Disease (MDRD) study-derived equations, over clearance of endogenous creatinine (Ccr) in achieving this aim. We were interested in knowing the accuracy of these equations in predicting the GFR in adult Nigerians with CKD.
We conducted a review of records of patients who were evaluated for CKD at the Nephrology Clinic of the Jos University Teaching Hospital between 2001 and 2003. We compared the CG and MDRD equations against the Ccr in predicting the GFR in 130 patients (88 males and 42 females) with CKD.
The means +/- standard deviation (SD) for the measured and predicted GFR by the CG and MDRD equations were similar (17.6 +/- 25.8 ml/min, 19.9 +/- 24.0 ml/min and 21.5 +/- 28.2 ml/min, respectively; analysis of variance [ANOVA], F = 0.68, P = 0.5). The mean difference between CG and Ccr was -2.2 +/- 14.8 ml/min, with discordance at Ccr values >25 ml/min. The mean difference between MDRD and Ccr was -3.9 +/- 18.1 ml/min, with discordance at Ccr values >40 ml/min.
The CG and MDRD equations provide reliable alternatives to measured Ccr in the estimation of the GFR in Nigerian patients with CKD.
在评估慢性肾脏病(CKD)患者时,需要估算肾小球滤过率(GFR),以便提供有关肾脏功能状态的信息。当前指南提倡使用预测方程,如Cockcroft-Gault(CG)公式和肾脏病饮食改良(MDRD)研究得出的方程,而非内生肌酐清除率(Ccr)来实现这一目标。我们想了解这些方程在预测成年尼日利亚CKD患者的GFR方面的准确性。
我们回顾了2001年至2003年期间在乔斯大学教学医院肾脏病诊所接受CKD评估的患者记录。我们将CG和MDRD方程与Ccr进行比较,以预测130例(88例男性和42例女性)CKD患者的GFR。
CG和MDRD方程测量和预测的GFR的均值±标准差(SD)相似(分别为17.6±25.8 ml/min、19.9±24.0 ml/min和21.5±28.2 ml/min;方差分析[ANOVA],F = 0.68,P = 0.5)。CG与Ccr之间的平均差异为-2.2±14.8 ml/min,在Ccr值>25 ml/min时出现不一致。MDRD与Ccr之间的平均差异为-3.9±18.1 ml/min,在Ccr值>40 ml/min时出现不一致。
在估算尼日利亚CKD患者的GFR时,CG和MDRD方程为测量的Ccr提供了可靠的替代方法。