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[血清肌酐水平和估算肾小球滤过率作为当今临床实践中肾功能的指标]

[Serum creatinine level and eGFR as the indices of renal function in present-day clinical practice].

作者信息

Kuć Kamil, Kiciński Paweł, Przybylska-Kuć Sylwia, Mosiewicz Jerzy, Myśliński Wojciech

机构信息

Katedra i Klinika Chorób Wewnetrznych Uniwersytetu Medycznego w Lublinie.

出版信息

Przegl Lek. 2010;67(7):491-5.

Abstract

The chronic kidney disease (CKD) is a polysymptomatic syndrome resulting from the reduction of active nephrons. It is estimated that the disease affects from 4.7-20% of adults. According to the actual knowledge, glomerular filtration rate (GFR) less than 60 ml/min/1.73 m2 is a significant risk factor for the cardiovascular diseases. The aim of our study was to assess the frequency of using the serum creatinine level and the estimated GFR (eGFR) as the indices of renal function in clinical practice. The study was performed amongst physicians working in non-academic departments of internal disease in the region of lubelskie voivodeships in 2008. An anonymous questionnaire of own composition consisting of 18 open and closed questions was used. The questions concerned the use of eGFR and serum creatinine level in everyday practice. 162 physicians were asked to fill the questionnaire, the percent of positive answers was 27.78% which is 45 questionnaires. The best parameter in evaluation of renal function, according to the asked physicians, was serum creatinine level (49% of all answers), eGFR (47%) and serum urea level or microalbuminuria (4%). Despite the actual recommendations, the serum creatinine level still remains the most popular routine parameter used to evaluate renal function. It seems that the knowledge concerning the diagnosing of CKD and the prophylaxis of its progression among physicians is insufficient. It concerns mainly physicians with no special training, working rather in profiled than in general medicine departments. Therefore, current educational programs concerning preventing and early diagnosis of CKD should be destinated mainly to these groups of physicians.

摘要

慢性肾脏病(CKD)是一种因活性肾单位减少而导致的多症状综合征。据估计,该疾病影响4.7%至20%的成年人。根据现有知识,肾小球滤过率(GFR)低于60 ml/min/1.73 m²是心血管疾病的一个重要危险因素。我们研究的目的是评估在临床实践中使用血清肌酐水平和估算肾小球滤过率(eGFR)作为肾功能指标的频率。该研究于2008年在卢布林省非学术性内科部门工作的医生中进行。使用了一份由18个开放式和封闭式问题组成的自行编制的匿名问卷。这些问题涉及日常实践中eGFR和血清肌酐水平的使用情况。162名医生被要求填写问卷,肯定回答的百分比为27.78%,即45份问卷。根据被询问的医生,评估肾功能的最佳参数是血清肌酐水平(占所有回答的49%)、eGFR(47%)以及血清尿素水平或微量白蛋白尿(4%)。尽管有实际的建议,但血清肌酐水平仍然是用于评估肾功能最常用的常规参数。看来医生们关于CKD诊断及其进展预防的知识不足。这主要涉及没有接受过特殊培训、主要在专科而非普通内科部门工作的医生。因此,当前关于CKD预防和早期诊断的教育项目应主要针对这些医生群体。

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