Arreola-Guerra José M, Rincón-Pedrero Rodolfo, Cruz-Rivera Cristino, Belmont-Pérez Teresa, Correa-Rotter Ricardo, Niño-Cruz José A
Nefrologia. 2014;34(5):591-8. doi: 10.3265/Nefrologia.pre2014.Jun.12538.
The performance of the CKD-EPI and MDRD formulae for estimating glomerular filtration rate (GFR) in patients of Hispanic origin with normal renal function has been poorly explored and requires validation in Mexico.
We included previously healthy Mexican adults. We obtained clinical variables and determined serum creatinine to calculate the CKD-EPI and MDRD-IDMS formulae. These results were compared with the gold standard (GFR measured by Tc99DTPA). We evaluated other clinical variables that could affect the performance of the CKD-EPI formula.
A total of 97 healthy volunteers were included, 55 males and 42 females; the mean age was 35.8 years old (18 to 73). Mean creatinine was 0.76mg/dl (±0.18). CKD-EPI performance was significantly better than MDRD-IDMS in all comparisons (bias, correlation and accuracy). The bias difference between the formulae was 6.08ml/min/1.73m2 (95% CI 2.58 to 9.58) (p<.001). Individuals with a body mass index (BMI) above 25kg/m2 displayed a better performance than the group with a lower BMI (difference of means 7.39ml/min/1.73m2; 95% CI 1.17 to 13.6 p<.02). Both formulae overestimated the GFR. BMI was significantly associated with the performance of the CKD-EPI formula (β 0.82; 95% CI 0.085 to 1.56 p=.029).
In healthy Mexican adults, the CKD-EPI formula is a better predictor of the mGFR than the MDRD-IDMS formula. BMI is significantly associated with the performance of the CKD-EPI formula and is better in those with a BMI greater than 25kg/m2. Both formulae overestimate mGFR.
对于估算肾功能正常的西班牙裔患者的肾小球滤过率（GFR），慢性肾脏病流行病学合作（CKD-EPI）公式和肾脏病饮食改良（MDRD）公式的表现尚未得到充分研究，且需要在墨西哥进行验证。
我们纳入了之前健康的墨西哥成年人。获取临床变量并测定血清肌酐，以计算CKD-EPI公式和MDRD-IDMS公式。将这些结果与金标准（用Tc99DTPA测量的GFR）进行比较。我们评估了其他可能影响CKD-EPI公式表现的临床变量。
共纳入97名健康志愿者，55名男性和42名女性；平均年龄为35.8岁（18至73岁）。平均肌酐为0.76mg/dl（±0.18）。在所有比较中（偏差、相关性和准确性），CKD-EPI公式的表现显著优于MDRD-IDMS公式。两个公式之间的偏差差异为6.08ml/min/1.73m2（95%置信区间2.58至9.58）（p<0.001）。体重指数（BMI）高于25kg/m2的个体比BMI较低的组表现更好（平均差异为7.39ml/min/1.73m2；95%置信区间1.17至13.6，p<0.02）。两个公式均高估了GFR。BMI与CKD-EPI公式的表现显著相关（β 0.82；95%置信区间0.085至（此处原文有误，应为1.56）1.56，p = 0.029）。
在健康的墨西哥成年人中，CKD-EPI公式比MDRD-IDMS公式更能准确预测估算肾小球滤过率（mGFR）。BMI与CKD-EPI公式的表现显著相关，BMI大于25kg/m2的个体表现更佳。两个公式均高估了mGFR。
