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在一大群人中使用MDRD方程和CKD-EPI方程估算肾小球滤过率(eGFR)用于慢性肾脏病(CKD)筛查的比较。

Comparison of estimated glomerular filtration rate (eGFR) using the MDRD and CKD-EPI equations for CKD screening in a large population.

作者信息

Giavarina D, Cruz D N, Soffiati G, Ronco C

机构信息

Dipartimento di Patologia Clinica, Vicenza, Italy.

出版信息

Clin Nephrol. 2010 Nov;74(5):358-63. doi: 10.5414/cnp74358.

Abstract

BACKGROUND/AIMS: recently, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) proposed a new equation for estimating glomerular filtration rate (eGFR), which could potentially replace the Modified Diet for Renal Disease Study (MDRD) equation in routine clinical use. Our aim was to evaluate the correlation between them and to compare the prevalence of each CKD stage using these two equations.

METHODS

we measured serum creatinine in 38,188 consecutive patients and calculated eGFR using the CKD-EPI and MDRD equations. We also compared the distribution of CKD stages for both equations.

RESULTS

there was very good correlation between eGFR estimated by CKD-EPI and MDRD at values < 60 ml/min × 1.73 m2, but not at higher values. Estimated prevalence of CKD (eGFR < 60 ml/min × 1.73 m2) was 5.9% with CKD-EPI and 7.5% with MDRD. Furthermore, the prevalence of CKD Stage 2 was lower with CKD-EPI (33.8% vs. 49.1%. with MDRD).

CONCLUSION

the use of the CKD-EPI equation results in a lower estimated prevalence of CKD, compared to the MDRD equation. This may have important implications for public health and clinical practice, as well as for future modification of guidelines for laboratories.

摘要

背景/目的:最近,慢性肾脏病流行病学协作组(CKD-EPI)提出了一种新的估算肾小球滤过率(eGFR)的方程,该方程可能会在常规临床应用中取代肾病研究改良饮食(MDRD)方程。我们的目的是评估它们之间的相关性,并使用这两个方程比较每个慢性肾脏病阶段的患病率。

方法

我们测量了38188例连续患者的血清肌酐,并使用CKD-EPI和MDRD方程计算eGFR。我们还比较了两个方程的慢性肾脏病阶段分布情况。

结果

当eGFR值<60 ml/min×1.73 m2时,CKD-EPI和MDRD估算的eGFR之间具有很好的相关性,但在较高值时则不然。CKD-EPI估算的慢性肾脏病(eGFR<60 ml/min×1.73 m2)患病率为5.9%,MDRD为7.5%。此外,CKD-EPI估算的2期慢性肾脏病患病率较低(分别为33.8%和49.1%,MDRD)。

结论

与MDRD方程相比,使用CKD-EPI方程估算的慢性肾脏病患病率较低。这可能对公共卫生和临床实践以及实验室指南的未来修订具有重要意义。

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