Hospital Pharmacy, University Hospital, LMU Munich, Munich, Germany.
Doctoral Program Clinical Pharmacy, University Hospital, LMU Munich, Munich, Germany.
Eur J Clin Pharmacol. 2020 Oct;76(10):1465-1470. doi: 10.1007/s00228-020-02932-x. Epub 2020 Jun 19.
Estimated glomerular filtration rate (eGFR) as calculated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation is used for detection of chronic kidney disease and drug dose adjustment. The purpose of the present study was to investigate the accuracy of freely available eGFR online calculators.
All identified CKD-EPI online calculators were run with five reference cases differing in age, sex, serum creatinine, and ethnicity. Conversion from eGFR (unit ml/min per 1.73 m) to eGFR (unit ml/min) and creatinine unit from milligramme/decilitre to micromole/litre was checked, if available.
Only 36 of 47 calculators (76.6%) produced accurate eGFR results for all reference cases. Eight of 47 (17.0%) calculators were considered as faulty because of errors relating to ethnicity (4 calculators), to conversion of the eGFR unit (2 calculators), to erroneous eGFR values without obvious explanation (2 calculators), to conversion of the creatinine unit (1 calculator), and to an error in the eGFR unit displayed (1 calculator). Overall, 28 errors were found (range 59 to 147% of the correct eGFR value), the majority concerning calculation of eGFR and the conversion to eGFR. Only 7 of 47 (14.9%) calculators offered conversion of the eGFR unit.
Erroneous calculations that might lead to inappropriate clinical decision-making were found in 8 of 47 calculators. Thus, online calculators should be evaluated more thoroughly after implementation. Conversion of eGFR units that might be needed for drug dose adjustments should be implemented more often.
慢性肾脏病流行病学合作组（CKD-EPI）方程估算的肾小球滤过率（eGFR）用于慢性肾脏病的检测和药物剂量调整。本研究旨在探讨免费 eGFR 在线计算器的准确性。
使用年龄、性别、血清肌酐和种族不同的 5 个参考病例对所有鉴定出的 CKD-EPI 在线计算器进行运行。如果可用，将 eGFR（单位 ml/min per 1.73 m）转换为 eGFR（单位 ml/min）和肌酐单位从毫克/分升转换为微摩尔/升。
只有 47 个计算器中的 36 个（76.6%）为所有参考病例生成了准确的 eGFR 结果。47 个计算器中有 8 个（17.0%）被认为有故障，原因包括种族相关错误（4 个计算器）、eGFR 单位转换错误（2 个计算器）、无明显解释的错误 eGFR 值（2 个计算器）、肌酐单位转换错误（1 个计算器）以及显示的 eGFR 单位错误（1 个计算器）。总共发现了 28 个错误（正确 eGFR 值的 59%至 147%之间），大部分涉及 eGFR 的计算和转换为 eGFR。47 个计算器中只有 7 个（14.9%）提供了 eGFR 单位的转换。
在 47 个计算器中发现了 8 个可能导致不适当临床决策的错误计算。因此，在实施后应更彻底地评估在线计算器。应更频繁地实施可能需要进行药物剂量调整的 eGFR 单位转换。
