Canales Muna T, Blackwell Terri, Ishani Areef, Taylor Brent C, Hart Allyson, Beyth Rebecca J, Ensrud Kristine E
Malcom-Randall VAMC, Department of Medicine, University of Florida, Gainesville, FL, USA.
Research Institute, California Pacific Medical Center, San Francisco, CA, USA.
Int J Nephrol. 2017;2017:8216878. doi: 10.1155/2017/8216878. Epub 2017 Mar 29.
. The Berlin Initiative Study (BIS) eGFR equations were developed specifically for aged populations, but their predictive validity compared to standard formulae is unknown in older women. . In a prospective study of 1289 community-dwelling older women (mean age 79.5 years), we compared the performance of the BIS1 SCr-based equation to the CKD-EPI and the BIS2 SCr- and Scysc-based equation to the CKD-EPI to predict cardiovascular and all-cause mortality. . Prevalence of specific eGFR category (i.e., ≥75, 60-74, 45-59, and <45) according to eGFR equation was 12.3%, 38.4%, 37.3%, and 12.0% for BIS1; 48.3%, 27.8%, 16.2%, and 7.8% for CKD-EPI; 14.1%, 38.6%, 37.6%, and 9.6% for BIS2; and 33.5%, 33.4%, 22.0%, and 11.1% for CKD-EPI, respectively. Over 9 ± 4 years, 667 (51.8%) women died. For each equation, women with eGFR <45 were at increased risk of mortality compared to eGFR ≥75 [adjusted HR (95% CI): BIS1, 1.5 (1.1-2.0); CKD-EPI, 1.7 (1.3-2.2); BIS2, 2.0 (1.4-2.8); CKD-EPI, 1.8 (1.4-2.3); -trend <0.01]. Net reclassification analyses found no material difference in discriminant ability between the BIS and CKD-EPI equations. Results were similar for cardiovascular death. . Compared to CKD-EPI, BIS equations identified a greater proportion of older women as having CKD but performed similarly to predict mortality risk. Thus, the BIS equations should not replace CKD-EPI equations to predict risk of death in older women.
柏林倡议研究（BIS）的估算肾小球滤过率（eGFR）方程是专门为老年人群开发的，但与标准公式相比，其在老年女性中的预测有效性尚不清楚。在一项对1289名社区居住老年女性（平均年龄79.5岁）的前瞻性研究中，我们比较了基于血清肌酐（SCr）的BIS1方程与慢性肾脏病流行病学协作组（CKD-EPI）方程，以及基于SCr和胱抑素C（Scysc）的BIS2方程与CKD-EPI方程预测心血管疾病和全因死亡率的性能。根据eGFR方程，特定eGFR类别（即≥75、60 - 74、45 - 59和<45）的患病率在BIS1中分别为12.3%、38.4%、37.3%和12.0%；在CKD-EPI中分别为48.3%、27.8%、16.2%和7.8%；在BIS2中分别为14.1%、38.6%、37.6%和9.6%；在CKD-EPI中分别为33.5%、33.4%、22.0%和11.1%。在9±4年的时间里，667名（51.8%）女性死亡。对于每个方程，与eGFR≥75的女性相比，eGFR<45的女性死亡风险增加[调整后风险比（95%置信区间）：BIS1为1.5（1.1 - 2.0）；CKD-EPI为1.7（1.3 - 2.2）；BIS2为2.0（1.4 - 2.8）；CKD-EPI为1.
