去除体表面积标准化可改善慢性肾脏病流行病学合作组方程对原始测量的肾小球滤过率的估算以及肥胖患者的药物剂量计算。
Removal of body surface area normalisation improves raw-measured glomerular filtration rate estimation by the Chronic Kidney Disease Epidemiology Collaboration equation and drug dosing in the obese.
作者信息
Chew-Harris J S C, Chin P K L, Florkowski C M, George P, Endre Z
机构信息
Clinical Biochemistry Unit, Canterbury Health Laboratories, Christchurch, New Zealand.
Pathology, University of Otago, Christchurch, New Zealand.
出版信息
Intern Med J. 2015 Jul;45(7):766-73. doi: 10.1111/imj.12791.
BACKGROUND/AIM: We aimed to compared estimated glomerular filtration rate (eGFR) according to the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI), with (mL/min/1.73 m(2) ) and without body surface area (BSA) normalisation (CKD-EPI_noBSA, mL/min) against measured (99m) Technetium - diethylenepentaacetic acid (Tc-DTPA GFR) (mL/min) in 222 individuals, including 80 with malignancy.
METHODS
BSA was calculated for each individual using the Du Bois equation. The CKD-EPI and CKD-EPI_noBSA equations were compared with measured Tc-DTPA GFR with respect to bias, proportion within 30% of GFR (P30) and root mean square error for predicting levels of GFR, and concordance in relation to carboplatin dosing.
RESULTS
The mean (SD) for BSA and measured GFR for the entire group was 1.99 (0.25) m(2) and 127 (41) mL/min respectively. The P30 for Tc-DTPA GFR was significantly higher with the CKD-EPI_noBSA (80%) than with the CKD-EPI equation (63%, P = 0.0001). In those with body mass index (BMI) > 30 kg/m(2) , the P30 values for the CKD-EPI_noBSA and CKD-EPI were 74% and 42% respectively (P < 0.0001). Carboplatin dosing concordance for the cancer patients using the CKD-EPI and CKD-EPI_noBSA equation was 71% and 56% respectively (P = 0.07). In 78 individuals with BMI > 30 kg/m(2) , concordance in relation to carboplatin dosing using CKD-EPI_noBSA was 65% compared with 26% with the CKD-EPI (P < 0.0001).
CONCLUSION
The CKD-EPI without normalisation (CKD-EPI_noBSA) equation was superior to the CKD-EPI equation in estimating raw-measured Tc-DTPA GFR (mL/min).
背景/目的：我们旨在比较根据慢性肾脏病流行病学合作组方程（CKD-EPI）计算的估计肾小球滤过率（eGFR），有（单位：mL/min/1.73 m²）和无体表面积（BSA）标准化（CKD-EPI_noBSA，单位：mL/min）时，与222名个体（包括80名恶性肿瘤患者）的测量值（99m）锝-二乙三胺五乙酸（Tc-DTPA GFR）（单位：mL/min）的差异。
方法
使用杜波依斯方程为每个个体计算BSA。将CKD-EPI和CKD-EPI_noBSA方程与测量的Tc-DTPA GFR在预测GFR水平的偏差、GFR的30%范围内的比例（P30）和均方根误差方面进行比较，并比较在卡铂给药方面的一致性。
结果
整个组的BSA平均值（标准差）和测量的GFR分别为1.99（0.25）m²和127（41）mL/min。CKD-EPI_noBSA的Tc-DTPA GFR的P30（80%）显著高于CKD-EPI方程（63%，P = 0.0001）。在体重指数（BMI）> 30 kg/m²的人群中，CKD-EPI_noBSA和CKD-EPI的P30值分别为74%和42%（P < 0.0001）。使用CKD-EPI和CKD-EPI_noBSA方程的癌症患者卡铂给药一致性分别为71%和56%（P = 0.07）。在78名BMI > 30 kg/m²的个体中，使用CKD-EPI_noBSA的卡铂给药一致性为65%，而使用CKD-EPI的为26%（P < 0.0001）。
结论
未进行标准化的CKD-EPI（CKD-EPI_noBSA）方程在估计原始测量的Tc-DTPA GFR（mL/min）方面优于CKD-EPI方程。
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