Department of Laboratory Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.
Ann Lab Med. 2019 Mar;39(2):205-208. doi: 10.3343/alm.2019.39.2.205.
The creatinine-based Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation can be calculated according to race, sex, and creatinine concentration (subgroup equation) or in the form expressed by one equation (single equation). Minor differences in the constants used in the CKD-EPI equations (subgroup vs single equations) could result in a significant difference in the estimated glomerular filtration rate (eGFR). We evaluated the impact of this difference in 79,709 Korean patients. The eGFR was calculated as an integer using the single and subgroup CKD-EPI equations. The differences in eGFR and GFR categories between the equations were analyzed. eGFR was higher in the subgroup equation than the single equation by 1 mL/min/1.73 m² for 12,476 (27.4%) Korean females. The GFR category based on the subgroup equation was reclassified using the single equation for 352 (0.77%) females. Based on the results, the constant of the single equation was optimized. There was no difference in eGFR values between equations using a multiplier of 1.0213 instead of 1.018 for the "white or other" females constant in the single CKD-EPI equation. Clinicians should carefully apply the CKD-EPI equation because eGFR values may differ by 1 mL/min/1.73 m² depending on the manner of calculation. To minimize these differences, the constants of the single equation should be revised.
基于肌酐的慢性肾脏病流行病学合作研究（CKD-EPI）方程可以根据种族、性别和肌酐浓度（亚组方程）进行计算，或者以一个方程（单方程）的形式表示。在 CKD-EPI 方程中使用的常数（亚组与单方程）的微小差异可能导致估计肾小球滤过率（eGFR）的显著差异。我们在 79709 名韩国患者中评估了这种差异的影响。使用单方程和亚组 CKD-EPI 方程将 eGFR 计算为整数。分析了方程之间 eGFR 和 GFR 分类的差异。对于 12476 名（27.4%）韩国女性，亚组方程的 eGFR 比单方程高 1 毫升/分钟/1.73 平方米。使用单方程对 352 名（0.77%）女性重新分类了基于亚组方程的 GFR 类别。根据结果，优化了单方程的常数。对于单 CKD-EPI 方程中的“白人或其他”女性常数，使用 1.0213 而不是 1.018 的乘数代替 1.018，方程的 eGFR 值没有差异。由于 eGFR 值可能因计算方式而异，因此临床医生应谨慎应用 CKD-EPI 方程，差异可能为 1 毫升/分钟/1.73 平方米。为了最大程度地减少这些差异，应修订单方程的常数。
