Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Japan.
Center for Information, Jichi Medical University, Japan.
Intern Med. 2021 Sep 1;60(17):2757-2764. doi: 10.2169/internalmedicine.6934-20. Epub 2021 Mar 15.
Objective We studied three types of estimated glomerular filtration rate (eGFR) equations and evaluated which type was strongly associated with comorbidities in living kidney transplantation (LKT) donors. Methods We compared the Japanese modified eGFR, Modification of Diet in Renal Disease, and Chronic Kidney Disease Epidemiology Collaboration equations (Jm-eGFR, Jm-MDRD, and Jm-CKD-EPI, respectively) for Japanese LKT donors with respect to their relationships with obesity, hypertension, diabetes, cardiovascular disease, and stroke. Results Of the 8,176 enrolled Japanese LKT donors, the eGFR calculated using Jm-CKD-EPI (eGFR/Jm-CKD-EPI) detected significant differences in 4 of 5 comorbidities between the comorbidity-positive and comorbidity-negative groups, whereas the eGFR calculated using Jm-MDRD (eGFR/Jm-MDRD) and Jm-eGFR (eGFR/Jm-eGFR) detected only 3 and 1 comorbidities, respectively. The area under the receiver operating characteristic curve of Jm-CKD-EPI was larger than those of Jm-eGFR and Jm-MDRD for all five comorbidities. Conclusion We found that the eGFR/Jm-CKD-EPI correlated better with comorbidities than the eGFR/Jm-eGFR and eGFR/Jm-MDRD in Japanese LKT donors. We recommend using the eGFR/Jm-CKD-EPI for the initial assessment of the renal function in LKT donor candidates when evaluating the presence of associated comorbidities.
我们研究了三种估算肾小球滤过率(eGFR)方程,并评估了哪种方程与活体肾移植(LKT)供者的合并症密切相关。
我们比较了日本改良 eGFR、肾脏病饮食改良试验和慢性肾脏病流行病学合作研究方程(Jm-eGFR、Jm-MDRD 和 Jm-CKD-EPI)在日本 LKT 供者中的表现,评估其与肥胖、高血压、糖尿病、心血管疾病和中风的关系。
在纳入的 8176 名日本 LKT 供者中,使用 Jm-CKD-EPI 计算的 eGFR(eGFR/Jm-CKD-EPI)在合并症阳性和阴性组之间的 5 种合并症中的 4 种中存在显著差异,而使用 Jm-MDRD(eGFR/Jm-MDRD)和 Jm-eGFR(eGFR/Jm-eGFR)计算的 eGFR 仅能检测到 3 种和 1 种合并症。对于所有 5 种合并症,Jm-CKD-EPI 的受试者工作特征曲线下面积均大于 Jm-eGFR 和 Jm-MDRD。
我们发现,与 Jm-eGFR 和 Jm-MDRD 相比,Jm-CKD-EPI 计算的 eGFR/Jm-CKD-EPI 与日本 LKT 供者的合并症相关性更好。我们建议在评估 LKT 供者候选者的肾功能时,使用 eGFR/Jm-CKD-EPI 来评估合并症的存在。