Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei 10449, Taiwan.
World J Gastroenterol. 2011 Oct 28;17(40):4532-8. doi: 10.3748/wjg.v17.i40.4532.
To evaluate the difference between the performance of the (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations in cirrhotic patients.
From Jan 2004 to Oct 2008, 4127 cirrhotic patients were reviewed. Patients with incomplete data with respect to renal function were excluded; thus, a total of 3791 patients were included in the study. The glomerular filtration rate (GFR) was estimated by the 4-variable MDRD (MDRD-4), 6-variable MDRD (MDRD-6), and CKD-EPI equations.
When serum creatinine was 0.7-6.8 mg/dL and 0.6-5.3 mg/dL in men and women, respectively, a significantly lower GFR was estimated by the MDRD-6 than by the CKD-EPI. Similar GFRs were calculated by both equations when creatinine was > 6.9 mg/dL and > 5.4 mg/dL in men and women, respectively. In predicting in-hospital mortality, estimated GFR obtained by the MDRD-6 showed better accuracy [81.72%; 95% confidence interval (CI), 0.94-0.95] than that obtained by the MDRD-4 (80.22%; 95%CI, 0.96-0.97), CKD-EPI (79.93%; 95%CI, 0.96-0.96), and creatinine (77.50%; 95%CI, 2.27-2.63).
GFR calculated by the 6-variable MDRD equation may be closer to the true GFR than that calculated by the CKD-EPI equation.
评估（CKD-EPI）和改良肾脏病饮食研究（MDRD）方程在肝硬化患者中的表现差异。
2004 年 1 月至 2008 年 10 月，共回顾了 4127 例肝硬化患者。排除肾功能数据不完整的患者；因此，共有 3791 例患者纳入研究。肾小球滤过率（GFR）通过 4 变量 MDRD（MDRD-4）、6 变量 MDRD（MDRD-6）和 CKD-EPI 方程进行估计。
当血清肌酐在男性为 0.7-6.8mg/dL，女性为 0.6-5.3mg/dL 时，MDRD-6 估计的 GFR 明显低于 CKD-EPI。当肌酐分别大于男性 6.9mg/dL 和女性 5.4mg/dL 时，两种方程计算出的 GFR 相似。在预测住院死亡率方面，MDRD-6 估计的 GFR 具有更好的准确性[81.72%；95%置信区间（CI），0.94-0.95]，优于 MDRD-4[80.22%；95%CI，0.96-0.97]、CKD-EPI[79.93%；95%CI，0.96-0.96]和肌酐[77.50%；95%CI，2.27-2.63]。
6 变量 MDRD 方程计算的 GFR 可能比 CKD-EPI 方程更接近真实 GFR。
