Salvador Cathrin L, Hartmann Anders, Åsberg Anders, Bergan Stein, Rowe Alexander D, Mørkrid Lars
Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.
Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Transplant Direct. 2017 Nov 8;3(12):e332. doi: 10.1097/TXD.0000000000000742. eCollection 2017 Dec.
Assessment of glomerular filtration rate (GFR) is important in kidney transplantation. The aim was to develop a kidney transplant specific equation for estimating GFR and evaluate against published equations commonly used for GFR estimation in these patients.
Adult kidney recipients (n = 594) were included, and blood samples were collected 10 weeks posttransplant. GFR was measured by Cr-ethylenediaminetetraacetic acid clearance. Patients were randomized into a reference group (n = 297) to generate a new equation and a test group (n = 297) for comparing it with 7 alternative equations.
Two thirds of the test group were males. The median (2.5-97.5 percentile) age was 52 (23-75) years, cystatin C, 1.63 (1.00-3.04) mg/L; creatinine, 117 (63-220) μmol/L; and measured GFR, 51 (29-78) mL/min per 1.73 m. We also performed external evaluation in 133 recipients without the use of trimethoprim, using iohexol clearance for measured GFR. The Modification of Diet in Renal Disease equation was the most accurate of the creatinine-equations. The new equation, estimated GFR (eGFR) = 991.15 × (1.120/([age] × [cystatin C] × [creatinine]); where sex is denoted: 0, female; 1, male, demonstrating a better accuracy with a low bias as well as good precision compared with reference equations. Trimethoprim did not influence the performance of the new equation.
The new equation demonstrated superior accuracy, precision, and low bias. The Modification of Diet in Renal Disease equation was the most accurate of the creatinine-based equations.
肾小球滤过率（GFR）评估在肾移植中至关重要。目的是开发一个用于估计GFR的肾移植专用方程，并与这些患者中常用的已发表的GFR估计方程进行对比评估。
纳入成年肾移植受者（n = 594），在移植后10周采集血样。采用铬-乙二胺四乙酸清除率测定GFR。将患者随机分为参照组（n = 297）以生成新方程，以及试验组（n = 297）用于将新方程与7个替代方程进行比较。
试验组三分之二为男性。年龄中位数（第2.5 - 97.5百分位数）为52（23 - 75）岁，胱抑素C为1.63（1.00 - 3.04）mg/L；肌酐为117（63 - 220）μmol/L；测量的GFR为每1.73平方米51（29 - 78）mL/分钟。我们还对133名未使用甲氧苄啶的受者进行了外部评估，采用碘海醇清除率测定GFR。肾脏病饮食改良方程是基于肌酐的方程中最准确的。新方程，估计GFR（eGFR）= 991.15 ×（1.120/（[年龄]×[胱抑素C]×[肌酐]）；其中性别表示为：0，女性；1，男性，与参照方程相比，显示出更好的准确性、低偏差以及良好的精密度。甲氧苄啶不影响新方程的性能。
新方程显示出卓越的准确性、精密度和低偏差。肾脏病饮食改良方程是基于肌酐的方程中最准确的。
