Department of Medicine (Section of Nephrology), Tulane University School of Medicine, New Orleans, Louisiana.
Am J Perinatol. 2011 Jun;28(6):425-30. doi: 10.1055/s-0030-1268712. Epub 2010 Nov 18.
Accurate estimation of the glomerular filtration rate (GFR) in patients with preeclampsia requires the collection of a 24-hour urine and can have important therapeutic and diagnostic implications. This procedure is often difficult or impossible to accomplish in this patient group. In this study, the Cockcroft-Gault, the Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulas were evaluated for their accuracy in determining GFR in the setting of preeclampsia. The estimated GFRs calculated from the above formulas were compared with the creatinine clearance values obtained from a 24-hour urine collections in 543 preeclamptic patients recruited from several large hospitals. Additionally, a set of new equations, preeclampsia GFR (PGFR), based on ethnicity, was created. The Cockcroft-Gault, MDRD, and CKD-EPI formulas were inaccurate in predicting GFR and both were significantly less accurate than PGFR. The latter formula provided an estimated GFR that was much closer to the creatinine clearance. Current GFR estimation equations based on serum creatinine values in nonpregnant patients are not reliable measures of renal function in patients with preeclampsia. The use of a new formula (PGFR) is recommended.
准确估计子痫前期患者的肾小球滤过率（GFR）需要收集 24 小时尿液，这可能具有重要的治疗和诊断意义。但在这个患者群体中，该程序往往难以完成甚至无法完成。本研究评估了 Cockcroft-Gault、肾脏病饮食改良试验（MDRD）和慢性肾脏病流行病学合作（CKD-EPI）公式在子痫前期患者中的准确性，以确定 GFR。将上述公式计算出的估计 GFR 与从几家大型医院招募的 543 例子痫前期患者的 24 小时尿液收集获得的肌酐清除率值进行比较。此外，还根据种族创建了一套新的基于种族的方程，即子痫前期肾小球滤过率（PGFR）。Cockcroft-Gault、MDRD 和 CKD-EPI 公式在预测 GFR 方面不准确，并且都明显不如 PGFR 准确。后一个公式提供的估计 GFR 更接近肌酐清除率。基于非妊娠患者血清肌酐值的当前 GFR 估计方程不是子痫前期患者肾功能的可靠指标。建议使用新公式（PGFR）。
