Department of Endocrinology, Xijing Hospital, the Fourth Military Medical University, Xi'an, 710032 Shaanxi Province, PR China.
J Endocrinol Invest. 2013 May;36(5):293-7. doi: 10.3275/8524. Epub 2012 Jul 24.
The Cockcroft-Gault equation, abbreviated Modification of Diet in Renal Disease (MDRD) equation, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and improved abbreviated MDRD equation were used to evaluate renal function in diabetic patients. However, little is known regarding their applicability and precision in Chinese diabetic patients.
To compare the accuracy of four methods evaluating Chinese diabetic patients' renal function.
This study included 329 Chinese diabetic patients. Standard GFR (sGFR) was measured via ⁹⁹mTc-DTPA dynamic renal imaging. Estimated GFR (eGFR) was calculated by four equations separately. Applicability of these four equations in Chinese diabetic patients was determined by correlation studies, agreement test, and receiver operating characteristic (ROC) curves.
For Chinese diabetic patients, four methods assessing eGFR correlated well with sGFR. Overall, eGFR calculated via improved abbreviated MDRD had less bias and greater accuracy than the other algorithms estimating GFR (p ≤ 0.01). For patients with sGFR ≥ 60 ml/min/1.73 m², all four equations significantly underestimated actual GFR, with the improved abbreviated MDRD equation best approximating actual GFR (p ≤ 0.01). Conversely, in patients with sGFR<60 ml/min/1.73 m², all four equations overestimated actual GFR; GFR(improved MDRD) was relatively the most accurate (p ≤ 0.01).
While all four equations were inaccurate, the improved abbreviated MDRD equation best diagnosed and stratified renal failure in Chinese diabetic patients.
Cockcroft-Gault 方程、简化肾脏病饮食改良公式（MDRD）方程、慢性肾脏病流行病学合作研究（CKD-EPI）方程和改良简化 MDRD 方程被用于评估糖尿病患者的肾功能。然而，对于这些方程在中国糖尿病患者中的适用性和准确性，人们知之甚少。
比较四种方法评估中国糖尿病患者肾功能的准确性。
本研究纳入了 329 例中国糖尿病患者。通过 ⁹⁹mTc-DTPA 动态肾显像测量标准肾小球滤过率（sGFR）。分别用四个方程计算估算肾小球滤过率（eGFR）。通过相关性研究、一致性检验和受试者工作特征（ROC）曲线来判断这四个方程在中国人糖尿病患者中的适用性。
对于中国糖尿病患者，四种评估 eGFR 的方法与 sGFR 相关性良好。总体而言，与其他估计 GFR 的算法相比，改良简化 MDRD 计算的 eGFR 偏差更小，准确性更高（p≤0.01）。对于 sGFR≥60 ml/min/1.73 m²的患者，所有四个方程均显著低估了实际 GFR，而改良简化 MDRD 方程最接近实际 GFR（p≤0.01）。相反，对于 sGFR<60 ml/min/1.73 m²的患者，所有四个方程均高估了实际 GFR；改良 MDRD 方程的准确性相对较高（p≤0.01）。
尽管所有四个方程都不准确，但改良简化 MDRD 方程在诊断和分层中国糖尿病患者肾功能衰竭方面效果最佳。
