Yan Chenyan, Wu Buyun, Zeng Ming, Yang Guang, Ouyang Chun, Zhang Bo, Wang Ningning, Xing Changying, Mao Huijuan
Clin Nephrol. 2019 May;91(5):301-310. doi: 10.5414/CN109420.
To understand the agreement, precision, and accuracy between other estimated glomerular filtration rate (eGFR) equations and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine-cystatin C equation (EPI_Cr_CysC).
We conducted a cross-sectional study of 1,913 CKD patients. The eGFRs were calculated separately by creatinine clearance rate and Cockcroft-Gault equation corrected for standard body surface area (Ccr_BSA and eCcr_BSA); CKD-EPI creatinine equation (EPI_Cr); CKD-EPI cystatin C equation (EPI_CysC); EPI_Cr_CysC equation; Modification of Diet in Renal Disease (MDRD) Study equation with standardized serum creatinine; and full-age spectrum creatinine equation (FAS). The EPI_Cr_CysC equation was used as the reference.
When compared with the EPI_Cr_CysC equation, the EPI_Cr equation achieved the highest agreement in eGFRs (Lin's concordance correlation coefficient = 0.936, 95% confidence interval (CI) = 0.930, 0.941). eCcr_BSA and EPI_Cr equations achieved the first and second highest percentage agreement in the accurate classification of CKD stage (72.55 vs. 71.25%). The MDRD equation had minimal bias and was closely followed by the EPI_Cr equation (median difference = -1.3, 95% CI = -2.0, -0.8 vs. median difference = 2.5, 95% CI = 1.7, 3.3 mL/min/1.73m). The EPI_CysC and EPI_Cr equations achieved the first and second highest precision (interquartile range (IQR) of the difference = 12.2, 95% CI = 11.6, 12.9 vs. IQR of the difference = 15.5, 95% CI = 14.7, 16.3 mL/min/1.73m). The EPI_Cr and MDRD equations performed similarly and both had the highest accuracy at 30% (1 - P = 18.6, 95% CI = 16.9, 20.4 vs. 1 - P = 18.6, 95% CI = 16.8, 20.3%).
CONCLUSION: For assessment of renal function, the EPI_Cr equation performed the best and remained an acceptable alternative to the EPI_Cr_CysC equation in the absence of cystatin C. .
了解其他估算肾小球滤过率（eGFR）方程与慢性肾脏病流行病学协作组（CKD-EPI）肌酐-胱抑素C方程（EPI_Cr_CysC）之间的一致性、精密度和准确性。
我们对1913例慢性肾脏病患者进行了一项横断面研究。分别通过肌酐清除率和校正标准体表面积的Cockcroft-Gault方程（Ccr_BSA和eCcr_BSA）、CKD-EPI肌酐方程（EPI_Cr）、CKD-EPI胱抑素C方程（EPI_CysC）、EPI_Cr_CysC方程、标准化血清肌酐的肾脏病膳食改良（MDRD）研究方程以及全年龄谱肌酐方程（FAS）来计算eGFR。以EPI_Cr_CysC方程作为参考。
与EPI_Cr_CysC方程相比，EPI_Cr方程在eGFR方面具有最高的一致性（林氏一致性相关系数=0.936，95%置信区间（CI）=0.930，0.941）。eCcr_BSA和EPI_Cr方程在慢性肾脏病分期的准确分类中达成的一致百分比分别位列第一和第二（72.55%对71.25%）。MDRD方程偏差最小，其次是EPI_Cr方程（中位数差异=-1.3，95%CI=-2.0，-0.8对中位数差异=2.5，95%CI=1.7，3.3 mL/min/1.73m²）。EPI_CysC和EPI_Cr方程的精密度分别位列第一和第二（差异的四分位数间距（IQR）=12.2，95%CI=11.6，12.9对差异的IQR=15.5，95%CI=14.7，16.3 mL/min/1.73m²）。EPI_Cr和MDRD方程表现相似，在30%时均具有最高的准确性（1-P=18.6，95%CI=16.9，20.4对1-P=18.6，95%CI=16.8，20.3%）。
对于肾功能评估，EPI_Cr方程表现最佳，在缺乏胱抑素C的情况下仍是EPI_Cr_CysC方程可接受的替代方案。
