Department of Public Health and Clinical Medicine, Umeå University, Umeå, S-901 87, Sweden.
Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden.
ESC Heart Fail. 2020 Jun;7(3):1150-1160. doi: 10.1002/ehf2.12643. Epub 2020 Feb 13.
Glomerular filtration rate is an important factor in management of heart failure (HF). Our objective was to validate eight creatinine-based equations for estimating glomerular filtration rate (eGFR) in an HF population against measured glomerular filtration rate.
One hundred forty-six HF patients (mean age 68 ± 13 years, mean left ventricular ejection fraction 45% ± 15) within a single-centre hospital that underwent Cr-EDTA clearance between 2010 and 2018 were included in this retrospective study. eGFR was estimated by means of Cockcroft-Gault ideal and actual weight, the Modification of Diet in Renal Disease Study (MDRD), simplified MDRD with isotope dilution mass spectroscopy traceable calibration, the Chronic Kidney Disease Epidemiology Collaboration, revised Lund-Malmö, full age spectrum, and the Berlin Initiative Study 1. Mean measured glomerular filtration rate was 42 mL/min/1.73 m . Pearson's correlation coefficient (r) had the highest precision for MDRD (r = 0.9), followed by revised Lund-Malmö (r = 0.88). All equations except MDRD (mean difference -4.8%) resulted in an overestimation of the renal function. The accuracy was below 75% for all equations except MDRD.
None of the exclusively creatinine-based methods was accurate in predicting eGFR in HF patients. Our findings suggest that more accurate methods are needed for determining eGFR in patients with HF.
肾小球滤过率是心力衰竭（HF）管理的一个重要因素。我们的目的是验证 8 种基于肌酐的方程，以评估它们在 HF 患者中的肾小球滤过率（eGFR）与实测肾小球滤过率的相关性。
本回顾性研究纳入了 2010 年至 2018 年间在单一中心医院接受 Cr-EDTA 清除率检测的 146 例 HF 患者（平均年龄 68 ± 13 岁，平均左心室射血分数 45% ± 15）。采用 Cockcroft-Gault 理想体重和实际体重、改良肾脏病饮食研究（MDRD）、简化 MDRD 同位素稀释质谱跟踪校准、慢性肾脏病流行病学合作研究、修订的 Lund-Malmö、全年龄谱和柏林倡议研究 1 方程估算 eGFR。实测肾小球滤过率的平均值为 42 mL/min/1.73 m 。Pearson 相关系数（r）对 MDRD 具有最高的精度（r = 0.9），其次是修订的 Lund-Malmö（r = 0.88）。除 MDRD 外，所有方程（平均差异-4.8%）均高估了肾功能。除 MDRD 外，所有方程的准确性均低于 75%。
在 HF 患者中，没有一种基于肌酐的方法能够准确预测 eGFR。我们的研究结果表明，需要更准确的方法来确定 HF 患者的 eGFR。
