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儿科肾移植患者中改良施瓦茨方程和新型CKiD肾小球滤过率方程的个体内变异性

Intraindividual variability of the modified Schwartz and novel CKiD GFR equations in pediatric renal transplant patients.

作者信息

Tsampalieros Anne, Lepage Nathalie, Feber Janusz

机构信息

Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.

出版信息

Pediatr Transplant. 2011 Nov;15(7):760-5. doi: 10.1111/j.1399-3046.2011.01568.x. Epub 2011 Aug 23.

Abstract

GFR in children can be obtained from a formula using SCr and height or various formulas including serum CysC. Recently, two new GFR formulas have been developed: (i) height and SCr-mSchwartz GFR and (ii) height, SCr, CysC, and serum urea (CKiD GFR). While these formulas proved to be accurate when compared to the gold standard, their use in children post-kidney Tx is yet to be assessed. A total of 1174 blood samples (urea, SCr and CysC) were analyzed from the post-Tx period in 24 Tx children (12 boys, median age = 8.6 yr) currently followed at our institution. CKiD GFR and mSchwartz GFR were compared using Bland-Altman analysis and the CV. The mSchwartz GFR overestimated the CKiD GFR (mean bias = 1.09 ± 0.14; 95% limits of agreements from 0.82 to 1.36). Median CV of CKiD GFR (10.3%) was significantly lower than that of mSchwartz GFR (15.0%), p = 0.04, and negatively correlated with the slope of GFR (r(2) = 0.34, p = 0.0026). In conclusion, CKiD GFR has a significantly lower intraindividual variation than mSchwartz GFR and may be better suited for longitudinal follow-up of patients post-Tx.

摘要

儿童的肾小球滤过率(GFR)可以通过使用血清肌酐(SCr)和身高的公式或包括血清胱抑素C(CysC)在内的各种公式来获得。最近,开发了两种新的GFR公式:(i)身高和SCr - mSchwartz GFR以及(ii)身高、SCr、CysC和血清尿素(CKiD GFR)。虽然与金标准相比,这些公式被证明是准确的,但它们在儿童肾移植术后的应用尚未得到评估。我们机构对目前随访的24名肾移植儿童(12名男孩,中位年龄 = 8.6岁)移植后的1174份血液样本(尿素、SCr和CysC)进行了分析。使用Bland - Altman分析和变异系数(CV)对CKiD GFR和mSchwartz GFR进行了比较。mSchwartz GFR高估了CKiD GFR(平均偏差 = 1.09 ± 0.14;95%一致性界限为0.82至1.36)。CKiD GFR的中位CV(10.3%)显著低于mSchwartz GFR的中位CV(15.0%),p = 0.04,并且与GFR的斜率呈负相关(r² = 0.34,p = 0.0026)。总之,CKiD GFR的个体内变异显著低于mSchwartz GFR,可能更适合肾移植术后患者的纵向随访。

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