Horio M, Yasuda Y, Kaimori J, Ichimaru N, Kakuta Y, Isaka Y, Matsuo S, Takahara S
Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, Osaka, Japan.
Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Transplant Proc. 2014;46(2):314-7. doi: 10.1016/j.transproceed.2013.11.151.
It was reported that the glomerula filtration rate (GFR) equation based on serum creatinine underestimated the GFR in potential kidney donors. Recently, the Japanese GFR equation based on standardized serum cystatin C was reported. Therefore, we assessed the performance of the equation in potential kidney donors.
Forty-five potential kidney donors from 2 hospitals were included. GFR was measured (mGFR) using inulin renal clearance. Serum creatinine was measured using the enzymatic method. Serum cystatin C was measured using a nephelometric immunoassay (Siemens) and calibrated to the standardized value traceable to ERM-DA471/IFCC using an equation reported previously. The estimated GFR (eGFR) was calculated using the Japanese GFR equation based on serum creatinine (eGFRcreat) and the Japanese GFR equation based on serum cystatin C (eGFRcys). Bias (mGFR - eGFR) and accuracy (P30) of the equations were evaluated.
Inulin clearance, eGFRcreat, and eGFRcys were 91.0 ± 18.2, 78.5 ± 18.8, and 93.3 ± 16.3 mL/min/1.73 m(2), respectively. Bias of eGFRcreat was 12.4 ± 15.8 mL/min/1.73 m(2) and significantly different from zero, indicating underestimation of GFR. Bias of eGFRcys was -2.3 ± 16.3 mL/min/1.73 m(2) and was not significantly different from zero, suggesting better performance. But, the precision (standard deviation [SD] of bias) and accuracy (P30: Percentage of participants with eGFR within 30% of mGFR) of eGFRcys were not better compared with eGFRcreat. Accuracies (P30) of eGFRcreat and eGFRcys were 87% (95% confidence interval [CI], 74-94) and 82% (95% CI, 69-91), respectively.
Bias of eGFRcys was better compared with eGFRcreat. But, the precision (SD of bias) and accuracy of eGFRcys were not superior compared with eGFRcreat in potential kidney donors.
据报道，基于血清肌酐的肾小球滤过率（GFR）方程会低估潜在肾脏供体的GFR。最近，有报道称日本基于标准化血清胱抑素C的GFR方程。因此，我们评估了该方程在潜在肾脏供体中的性能。
纳入来自2家医院的45名潜在肾脏供体。使用菊粉肾清除率测量GFR（mGFR）。采用酶法测量血清肌酐。采用散射比浊免疫分析法（西门子）测量血清胱抑素C，并使用先前报道的方程将其校准为可溯源至ERM-DA471/IFCC的标准化值。使用基于血清肌酐的日本GFR方程（eGFRcreat）和基于血清胱抑素C的日本GFR方程（eGFRcys）计算估算的GFR（eGFR）。评估方程的偏差（mGFR - eGFR）和准确性（P30）。
菊粉清除率、eGFRcreat和eGFRcys分别为91.0±18.2、78.5±18.8和93.3±16.3 mL/min/1.73 m²。eGFRcreat的偏差为12.4±15.8 mL/min/1.73 m²，与零有显著差异，表明GFR被低估。eGFRcys的偏差为-2.3±16.3 mL/min/1.73 m²，与零无显著差异，提示性能更好。但是，与eGFRcreat相比，eGFRcys的精密度（偏差的标准差[SD]）和准确性（P30：eGFR在mGFR的30%范围内的参与者百分比）并无优势。eGFRcreat和eGFRcys的准确性（P30）分别为87%（95%置信区间[CI]，74 - 94）和82%（95% CI，69 - 91）。
与eGFRcreat相比，eGFRcys的偏差更好。但是，在潜在肾脏供体中，eGFRcys的精密度（偏差的SD）和准确性并不优于eGFRcreat。
