Jalalonmuhali Maisarah, Lim Soo Kun, Md Shah Mohammad Nazri, Ng Kok Peng
Department of Medicine, University Malaya Medical Centre, 59100, Kuala Lumpur, Malaysia.
Department of Biomedical Imaging, University Malaya Medical Centre, 59100, Kuala Lumpur, Malaysia.
BMC Nephrol. 2017 Dec 13;18(1):363. doi: 10.1186/s12882-017-0776-2.
Accurate measurement of renal function is important: however, radiolabelled gold standard measurement of GFR is highly expensive and can only be used on a very limited scale. We aim to compare the performance of Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equations in the multi-ethnic population attending University Malaya Medical Centre (UMMC).
This is a cross-sectional study recruiting patients, who attend UMMC Nephrology clinics on voluntary basis. 51-Chromium EDTA (Cr-EDTA) plasma level was used to measure the reference GFR. The serum creatinine was determined by IDMS reference modified Jaffe kinetic assay (Cr). The predictive capabilities of MDRD and CKD-EPI based equations were calculated. Data was analysed using SPSS version 20 and correlation, bias, precision and accuracy were determined.
A total of 113 subjects with mean age of 58.12 ± 14.76 years and BMI of 25.99 ± 4.29 kg/m were recruited. The mean reference GFR was 66.98 ± 40.65 ml/min/1.73m, while the estimated GFR based on MDRD and CKD-EPI formula were 62.17 ± 40.40, and 60.44 ± 34.59, respectively. Both MDRD and CKD-EPI were well-correlated with reference GFR (0.806 and 0.867 respectively) and statistically significant with p < 0.001. In the overall cohort, although MDRD had smaller bias than CKD-EPI (4.81 vs. 6.54), CKD-EPI was more precise (25.22 vs. 20.29) with higher accuracy within 30% of measured GFR (79.65 vs. 86.73%).
The CKD-EPI equation appeared to be more precise and accurate than the MDRD equation in estimating GFR in our cohort of multi-ethnic populations in Malaysia.
准确测量肾功能很重要；然而，放射性标记的肾小球滤过率（GFR）金标准测量成本高昂，且只能在非常有限的范围内使用。我们旨在比较肾脏病饮食改良（MDRD）方程和慢性肾脏病流行病学合作（CKD-EPI）方程在马来亚大学医学中心（UMMC）多民族人群中的表现。
这是一项横断面研究，自愿招募到UMMC肾脏病诊所就诊的患者。采用51-铬乙二胺四乙酸（Cr-EDTA）血浆水平来测量参考GFR。血清肌酐通过同位素稀释质谱法（IDMS）参考改良杰氏动力学测定法（Cr）进行测定。计算基于MDRD和CKD-EPI方程的预测能力。使用SPSS 20版对数据进行分析，并确定相关性、偏差、精密度和准确性。
共招募了113名受试者，平均年龄为58.12±14.76岁，体重指数为25.99±4.29kg/m²。平均参考GFR为66.98±40.65ml/min/1.73m²，而基于MDRD和CKD-EPI公式估算的GFR分别为62.17±40.40和60.44±34.59。MDRD和CKD-EPI与参考GFR均具有良好的相关性（分别为0.806和0.867），且p<0.001，具有统计学意义。在整个队列中，虽然MDRD的偏差比CKD-EPI小（4.81对6.54），但CKD-EPI更精确（25.22对20.29），在测量GFR的30%范围内准确性更高（79.65%对86.73%）。
在我们马来西亚多民族人群队列中，CKD-EPI方程在估算GFR方面似乎比MDRD方程更精确和准确。
