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估计肾小球滤过率与蛋白尿:诊断、分期及预后

Estimated glomerular filtration rate and albuminuria: diagnosis, staging, and prognosis.

作者信息

Komenda Paul, Rigatto Claudio, Tangri Navdeep

机构信息

Division of Nephrology, Seven Oaks General Hospital, University of Manitoba, Winnipeg, Manitoba, Canada.

出版信息

Curr Opin Nephrol Hypertens. 2014 May;23(3):251-7. doi: 10.1097/01.mnh.0000444910.55665.e8.

Abstract

PURPOSE OF REVIEW

To describe the relationship between estimated glomerular filtration rate (eGFR), albuminuria, and important outcomes for patients with chronic kidney disease (CKD). The first part of the review presents the evidence linking eGFR and albuminuria to important clinical outcomes, and the second part highlights the importance of these risk relationships across multiple subgroups and in clinical risk prediction.

RECENT FINDINGS

Investigators have used data from large population-based cohort studies and conducted collaborative meta-analyses to definitively establish the relationship between eGFR, albuminuria, and adverse clinical outcomes. Recent systematic reviews have also highlighted the importance of these variables in predicting the risk of kidney failure and all-cause mortality.

SUMMARY

eGFR and albuminuria are important independent risk factors for kidney failure, acute kidney injury, and all-cause or cardiovascular mortality. These relationships are independent of age, sex, race, or ethnicity. eGFR and albuminuria can be combined with other demographic variables to accurately predict the risk of kidney failure and should be measured concurrently to determine diagnosis, staging, and prognosis in patients with CKD.

摘要

综述目的

描述估算肾小球滤过率(eGFR)、蛋白尿与慢性肾脏病(CKD)患者重要预后之间的关系。综述的第一部分阐述了将eGFR和蛋白尿与重要临床预后相联系的证据,第二部分强调了这些风险关系在多个亚组及临床风险预测中的重要性。

最新发现

研究人员利用基于人群的大型队列研究数据并开展协作性荟萃分析,以明确确立eGFR、蛋白尿与不良临床预后之间的关系。近期的系统评价也突出了这些变量在预测肾衰竭风险和全因死亡率方面的重要性。

总结

eGFR和蛋白尿是肾衰竭、急性肾损伤以及全因或心血管死亡率的重要独立危险因素。这些关系独立于年龄、性别、种族或民族。eGFR和蛋白尿可与其他人口统计学变量相结合,以准确预测肾衰竭风险,并且应同时进行测量,以确定CKD患者的诊断、分期和预后。

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