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评估孟加拉国健康成年潜在肾脏捐赠者的肾小球滤过率:不同预测方程与二乙三胺五乙酸肾图测量的肾小球滤过率的比较。

Assessing glomerular filtration rate in healthy adult potential kidney donors in Bangladesh: a comparison of various prediction equations with measured glomerular filtration rate by diethylentriamine pentaacetic acid renogram.

作者信息

Jahan F, Chowdhury M N U, Mahbub T, Arafat S M, Jahan S, Hossain M, Khan M F

出版信息

Bangladesh Med Res Counc Bull. 2013 Aug;39(2):74-9. doi: 10.3329/bmrcb.v39i2.19646.

Abstract

To ensure that potential kidney donors in Bangladesh have no renal impairment, it is extremely important to have accurate methods for evaluating the glomerular filtration rate (GFR). We evaluated the performance of serum creatinine based GFR in healthy adult potential kidney donors in Bangladesh to compare GFR determined by DTPA with that determined by various prediction equations. In this study GFR in 61 healthy adult potential kidney donors were measured with 99mTc-diethylenetriamine penta-acetic acid (DTPA) renogram. We also estimated GFR using a four variable equation modification of diet in renal disease (MDRD), Cockcroft-Gault creatinine clearance (CGCrCl), Cockcroft-Gault glomerular filtration rate (CG-GFR). The mean age of study population was 34.31 +/- 9.46 years and out of them 65.6% was male. In this study mean mGFR was 85.4 +/- 14.8. Correlation of estimated GFR calculated by CG-CrCl, CG-GFR and MDRD were done with measured GFR DTPA using quartile. Kappa values were also estimated which was found to be 0.104 for (p = 0.151), 0.336 for (p = 0.001) and 0.125 for (p = 0.091) respectively. This indicates there is no association between estimated GFR calculated by CG-CrCl, CG-GFR, MDRD with measured GFR DTPA. These results show poor performance of these equations in evaluation of renal function among healthy population and also raise question regarding validity of these equations for assessment of renal function in chronic kidney disease in our population.

摘要

为确保孟加拉国潜在的肾脏捐赠者没有肾功能损害,拥有准确评估肾小球滤过率(GFR)的方法极为重要。我们评估了基于血清肌酐的GFR在孟加拉国健康成年潜在肾脏捐赠者中的表现,以比较由二乙三胺五乙酸(DTPA)测定的GFR与由各种预测方程测定的GFR。在本研究中,用99mTc - 二乙三胺五乙酸(DTPA)肾图测量了61名健康成年潜在肾脏捐赠者的GFR。我们还使用肾病饮食四变量修正方程(MDRD)、Cockcroft - Gault肌酐清除率(CGCrCl)、Cockcroft - Gault肾小球滤过率(CG - GFR)来估算GFR。研究人群的平均年龄为34.31±9.46岁,其中65.6%为男性。在本研究中,平均mGFR为85.4±14.8。使用四分位数对CG - CrCl、CG - GFR和MDRD计算的估算GFR与测量的DTPA - GFR进行相关性分析。还估算了kappa值,发现CG - CrCl的kappa值为0.104(p = 0.151),CG - GFR的kappa值为0.336(p = 0.001),MDRD的kappa值为0.125(p = 0.091)。这表明CG - CrCl、CG - GFR、MDRD计算的估算GFR与测量的DTPA - GFR之间没有关联。这些结果表明这些方程在评估健康人群肾功能方面表现不佳,也对这些方程在评估我国人群慢性肾脏病肾功能方面的有效性提出了质疑。

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