Dr Samir Kumar Das, Assistant Professor, Department of Nephrology, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
Mymensingh Med J. 2021 Jan;30(1):35-42.
This cross sectional comparative study was conducted in the Nephrology and Medicine outdoor and in-patients department of Mymensingh Medical College Hospital, Bangladesh from April 2014 to March 2015. A total of 100 patients with CKD and 100 healthy subjects were included in the study. Data were collected by interview of the patients, clinical examination and laboratory investigations using a semi-structured case record form. Among all subjects, 50.0% had no CKD and 50.0% patients had CKD: Stage 3 CKD were 8.5%, CKD Stage 4 CKD were 21.0%, CKD Stage 5 CKD were 20.5%. Serum creatinine was 4.32±3.08mg/dl in patients with CKD and 1.00±0.22mg/dl was in healthy subjects. Mean±SD of CCR/ml/min was found 17.67±11.63ml/min in patients with CKD and 79.31±13.31ml/min was found in healthy subjects. On the other hand, Mean±SD CCCR/ml/m/1.73m² was found 19.79±12.85 ml/m/1.73m² in patient with CKD and healthy subjects had 83.83±13.33 ml/m/1.73m². Urinary creatinine was 45.59±15.63 & 57.66±11.45mg/dl respectively. CKD-EPI eGFR was 22.10±15.02 & 90.61±23.27ml/m/1.73m²; MDRD eGFR was 22.15±14.18 & 89.35±26.19 ml/m/1.73m² respectively. Difference between all the variables between CKD group and healthy group was found statistically significant (p<0.001). CKD-EPIeGFR and MDRDeGFR were increased both in CKD patients and healthy subjects in respect to CCR and CCCR. There was a strong positive correlation between CCCR (ml/m/1.73m2) and CKD-EPI (ml/m/1.73m²) among all patients (r=0.934 and p<0.001) and also a positive correlation of CCCR with MDRD among all patients (r=0.913 and p<0.001). A positive correlation of CCCR was found with CKD-EPIeGFR among CKD patients (r=0.848 and p<0.001). A positive correlation of CCCR was also found with MDRDeGFR among CKD patients (r=0.841, p<0.001). There are positive correlations between CCCR and CKD/EPI among healthy subjects (r=0.616 and p<0.05) and between CCCR with MDRD among healthy subjects (r=0.568 and p<0.05). Various formulae were used to calculate GFR on the basis of serum creatinine levels. The Overall correlation of population (healthy and CKD patients) between CCCR and CKD EPI and MDRD formula was (r=0.93 and 0.91) respectively, among CKD patients it was (r=0.848 and r=0.841) in healthy subjects it was (r=0.616 and r=0.568) respectively. CKD EPI eGFR and MDRD eGFR formula had fairly good correlation with conventional 24 hours creatinine clearance in both CKD patient and healthy subjects, there was even more strong correlation especially in CKD patients. The performance of CKD-EPI equation is better than MDRD equation to estimate the eGFR in both CKD patients and healthy subjects.
本横断面对比研究在孟加拉国 Mymensingh 医学院医院的肾病和内科门诊进行，时间为 2014 年 4 月至 2015 年 3 月。共有 100 名 CKD 患者和 100 名健康受试者纳入研究。通过对患者的访谈、临床检查和实验室调查，使用半结构式病例记录表收集数据。所有受试者中，50.0%没有 CKD，50.0%的患者有 CKD：CKD 第 3 期为 8.5%，CKD 第 4 期为 21.0%，CKD 第 5 期为 20.5%。CKD 患者的血清肌酐为 4.32±3.08mg/dl，健康受试者为 1.00±0.22mg/dl。CKD 患者的 CCR/ml/min 平均值±标准差为 17.67±11.63ml/min，健康受试者为 79.31±13.31ml/min。另一方面，CKD 患者的 CCCR/ml/m/1.73m² 平均值±标准差为 19.79±12.85ml/m/1.73m²，健康受试者为 83.83±13.33ml/m/1.73m²。尿肌酐分别为 45.59±15.63 和 57.66±11.45mg/dl。CKD-EPI eGFR 分别为 22.10±15.02 和 90.61±23.27ml/m/1.73m²；MDRD eGFR 分别为 22.15±14.18 和 89.35±26.19ml/m/1.73m²。CKD 组和健康组之间所有变量之间的差异均具有统计学意义（p<0.001）。在 CKD 患者和健康受试者中，CCR 和 CCCR 均升高，CKD-EPIeGFR 和 MDRDeGFR 也升高。所有患者的 CCCR（ml/m/1.73m2）与 CKD-EPI（ml/m/1.73m²）之间存在很强的正相关（r=0.934，p<0.001），并且 CCCR 与所有患者的 MDRD 之间也存在正相关（r=0.913，p<0.001）。在 CKD 患者中，CCCR 与 CKD-EPIeGFR 之间存在正相关（r=0.848，p<0.001）。在 CKD 患者中，CCCR 与 MDRDeGFR 之间也存在正相关（r=0.841，p<0.001）。在健康受试者中，CCCR 与 CKD/EPI 之间存在正相关（r=0.616，p<0.05），与健康受试者的 MDRD 之间也存在正相关（r=0.568，p<0.05）。基于血清肌酐水平，各种公式用于计算 GFR。人群（健康和 CKD 患者）的整体相关性（r=0.93 和 0.91）在 CKD 患者中，CCCR 与 CKD-EPI 和 MDRD 公式之间的相关性分别为（r=0.848 和 r=0.841），在健康受试者中，CCCR 与 CKD-EPI 和 MDRD 公式之间的相关性分别为（r=0.616 和 r=0.568）。CKD-EPI eGFR 和 MDRD eGFR 公式与 CKD 患者和健康受试者的 24 小时肌酐清除率具有相当好的相关性，尤其是在 CKD 患者中，相关性更强。在 CKD 患者和健康受试者中，CKD-EPI 方程的性能优于 MDRD 方程来估计 eGFR。
