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估算高血压患者的肾小球滤过率:慢性肾脏病流行病学协作组(CKD-EPI)和肾脏病饮食改良研究(MDRD)方程的比较。

Estimating glomerular filtration rate in hypertensive subjects: comparison of the chronic kidney disease epidemiology collaboration (CKD-EPI) and modification of diet in renal disease (MDRD) study equations.

机构信息

Central Satakunta Health Federation of Municipalities, Harjavalta, Finland. paivi.e.korhonen@fi mnet.fi

出版信息

Ann Med. 2012 Aug;44(5):487-93. doi: 10.3109/07853890.2011.580775. Epub 2011 Dec 12.

Abstract

BACKGROUND

The Modification of Diet in Renal Disease (MDRD) Study equation is the most commonly used formula for estimation of glomerular filtration rate (eGFR). Recently, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) developed a new equation to provide a more accurate estimate of GFR among individuals with normal or mildly reduced renal function.

AIM

To compare the MDRD and CKD-EPI equations in hypertensive population treated in general practice.

METHODS

The MDRD and CKD-EPI equations were applied to a cohort of 994 hypertensive subjects aged 45-70 years without cardiovascular or renal disease or previously known diabetes.

RESULTS

The prevalence of CKD stage 3 (eGFR 30-59 mL/min per 1.73 m(2)) was 6.7% (95% CI 5.3-8.5) (67/994) according to the MDRD formula and 3.7% (95% CI 2.6-5.1) (37/994) according to the CKD-EPI formula. Of the 67 subjects classified as having CKD stage 3 according to the MDRD equation, 30 (44.8%) were reclassified as 'no-CKD' by the CKD-EPI equation. These subjects were mostly women 26/30 (87.7%).

CONCLUSION

Using the CKD-EPI equation leads to lower prevalence estimates for CKD than the MDRD equation in a hypertensive population treated in general practice.

摘要

背景

改良肾脏病饮食研究(MDRD)方程是目前最常用于估算肾小球滤过率(eGFR)的公式。最近,慢性肾脏病流行病学合作研究组(CKD-EPI)开发了一种新的方程,旨在为肾功能正常或轻度降低的个体提供更准确的 GFR 估算值。

目的

比较 MDRD 和 CKD-EPI 方程在普通实践中治疗的高血压人群中的应用。

方法

将 MDRD 和 CKD-EPI 方程应用于一个 994 名年龄在 45-70 岁、无心血管或肾脏疾病或既往已知糖尿病的高血压患者队列。

结果

根据 MDRD 公式,CKD 第 3 期(eGFR 30-59 mL/min/1.73 m²)的患病率为 6.7%(95%CI 5.3-8.5)(994 例中有 67 例),而根据 CKD-EPI 公式为 3.7%(95%CI 2.6-5.1)(994 例中有 37 例)。在根据 MDRD 方程被归类为 CKD 第 3 期的 67 例患者中,有 30 例(44.8%)根据 CKD-EPI 方程重新归类为“非 CKD”。这些患者主要为女性 26/30(87.7%)。

结论

在普通实践中治疗的高血压人群中,与 MDRD 方程相比,CKD-EPI 方程用于估算 CKD 的患病率较低。

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