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使用Cockcroft-Gault方程估算的肌酐清除率与圣经临床医院患者实际测定值之间的一致性分析。

Analysis of the concordance between the estimated values of creatinine clearance using the Cockcroft-Gault equation and the real value determined in patients from the Hospital Clínica Bíblica.

作者信息

Chaverri-Fernández Jose Miguel, Zavaleta-Monestel Esteban, Díaz-Madriz Jose Pablo, Ortiz-Ureña Angie, Ramírez-Hernández Monica, Trejos-Morales Karina

机构信息

Department of Pharmacology, Toxicology, and Drug Dependence of the School of Pharmacy, Universidad de Costa Rica. Clinical Pharmacist, Hospital Clínica Bíblica, San José..

Head of Pharmacy at the Hospital Clínica Bíblica, San José..

出版信息

Farm Hosp. 2016 Jan 1;40(1):3-13. doi: 10.7399/fh.2016.40.1.8859.

DOI:10.7399/fh.2016.40.1.8859
PMID:26882829
Abstract

OBJECTIVE

to analyze the effect of the modifications in the Cockcroft-Gault equation for creatinine clearance rate determination (CrCl) and its concordance with the real value determined from 24-hours urine collection in a sample of Latin American patients hospitalized in San José de Costa Rica.

METHOD

an observational, retrospective study, with patients submitted to a 24-hour urine collection test, and who met the inclusion criteria. The real and estimated values of creatinine clearance were determined, and their concordance was measured by applying the Intraclass Correlation Coefficient; a descriptive analysis of data was also conducted.

RESULTS

there were 507 subjects (61% men); their age was described (ME = 60 years SD = 17 years), as well as their height (ME = 1.66 m SD = 0.09 m), current weight (ME =75 kg SD = 15 kg), body mass index (ME = 27.3 kg/m2 SD = 4.76 kg/m2) and endogenous creatinine clearance rates (ME = 69.72 ml/min SD = 33 ml/min). The best concordance with the equation was obtained with current weight values and serum creatinine without rounding.

CONCLUSIONS

the application of the Cockcroft-Gault equation that matches more closely the real value is the one that uses current weight and does not round creatinine values below 1 mg/dL. It is suggested to conduct a prospective analysis, determining other variables that could affect CrCl real measures, and to replicate this methodology in specific populations. *ME: Mean **SD: Standard Deviation.

摘要

目的

分析在哥斯达黎加圣何塞住院的拉丁美洲患者样本中,用于测定肌酐清除率(CrCl)的Cockcroft - Gault方程的修正效果及其与24小时尿液收集所测定的实际值的一致性。

方法

一项观察性回顾性研究,纳入接受24小时尿液收集测试且符合纳入标准的患者。测定肌酐清除率的实际值和估计值,并通过应用组内相关系数测量它们的一致性;还对数据进行了描述性分析。

结果

有507名受试者(61%为男性);描述了他们的年龄(中位数 = 60岁,标准差 = 17岁)、身高(中位数 = 1.66米,标准差 = 0.09米)、当前体重(中位数 = 75千克,标准差 = 15千克)、体重指数(中位数 = 27.3千克/平方米,标准差 = 4.76千克/平方米)和内生肌酐清除率(中位数 = 69.72毫升/分钟,标准差 = 33毫升/分钟)。使用当前体重值和未进行四舍五入的血清肌酐时,该方程与实际值的一致性最佳。

结论

与实际值匹配度更高的Cockcroft - Gault方程应用是使用当前体重且不对低于1毫克/分升的肌酐值进行四舍五入的方程。建议进行前瞻性分析,确定可能影响CrCl实际测量值的其他变量,并在特定人群中重复此方法。*ME:均值 **SD:标准差

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