El-Minshawy Osama Mohamed, El-Bassuoni Eman
Department of Internal Medicine, El Minia University School of Medicine, El Minia, Egypt.
Iran J Kidney Dis. 2012 Jul;6(4):262-8.
Assessment of glomerular filtration rate (GFR) is the best index of kidney functions. We aimed to determine the accuracy of El-Minia equation for estimation of GFR in different stages of chronic kidney disease (CKD) in the El-Minia population of CKD patients, in comparison to other proposed equations.
The study included 320 isotopic GFR measurements by 99m-Tc technetium diethylene triamine pentaacetic acid. Patients were categorized into the five CKD stages based on this measurement, and estimated GFRs based on the El-Minia, Cockroft-Gault, Chronic Kidney Disease Epidemiology Collaboration, Modification of Diet in Renal Disease (MDRD), abbreviated MDRD, Walser, Nankivell, Cockcroft-Gault, and Mayo Clinic equations were validated using the National Kidney Foundation guidelines.
The El-Minia Equation showed the best performance in all 5 stages of CKD, except for stage 1, in which the Cockroft-Gault equation showed the best performance (44% within ± 10% error). In addition, the El-Minia equation provided the best accuracy to classify CKD stages, except for stage 4, in which the MDRD gave the best accuracy (82%). Worsening of the accuracy was documented in all the eight equations with more severe stages of kidney disease. These results were not significantly changed when the analyses were restricted to diabetic patients.
The El-Minia equation represents a better estimation of GFR in all stages of CKD than other published equations for CKD patients in El-Minia, Egypt. This equation was the best one for classification of CKD in these patients.
肾小球滤过率(GFR)评估是肾功能的最佳指标。我们旨在确定与其他提出的方程相比,埃尔明亚方程在埃尔明亚慢性肾脏病(CKD)患者群体不同阶段估算GFR的准确性。
该研究纳入了320例采用99m锝二乙三胺五乙酸进行的同位素GFR测量。根据此测量结果将患者分为五个CKD阶段,并依据埃尔明亚、考克饶夫-高尔特、慢性肾脏病流行病学协作组、肾脏病饮食改良(MDRD)简化版MDRD、瓦尔泽、南基韦尔、考克饶夫-高尔特和梅奥诊所方程估算GFR,并使用美国国立肾脏基金会指南进行验证。
埃尔明亚方程在CKD的所有5个阶段表现最佳,但在1期时考克饶夫-高尔特方程表现最佳(误差在±10%以内的占44%)。此外,埃尔明亚方程在对CKD阶段进行分类时准确性最高,但在4期时MDRD方程准确性最高(82%)。随着肾脏疾病阶段加重,所有八个方程的准确性均有所下降。当分析仅限于糖尿病患者时,这些结果无显著变化。
对于埃及埃尔明亚的CKD患者,与其他已发表的方程相比,埃尔明亚方程在CKD的所有阶段对GFR的估算更佳。该方程是这些患者CKD分类的最佳方程。