估算妊娠期肾小球滤过率：基于血清肌酐的Nanra方程和慢性肾脏病流行病学合作组（CKD-EPI）方程的评估
Estimating the glomerular filtration rate in pregnancy: The evaluation of the Nanra and CKD-EPI serum creatinine-based equations.
作者信息
Gao Michael, Vilayur Eswari, Ferreira David, Nanra Ranjit, Hawkins Joan
机构信息
Department of Nephrology, John Hunter Hospital, Newcastle, Australia.
School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.
出版信息
Obstet Med. 2021 Mar;14(1):31-34. doi: 10.1177/1753495X20904177. Epub 2020 Mar 19.
AIM
To compare the performance of the Nanra and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for estimating glomerular filtration rate in pregnancy against the 24 h urine creatinine clearance.
METHODS
Pregnant women had 24 h urine collections with simultaneous serum creatinine levels. Measured 24 h urine creatinine clearance was compared to two equations: Nanra and CKD-EPI. Level of concordance was measured, with an bias acceptance of ±15 ml/min/1.73 m.
RESULTS
A total of 53 synchronous urine and serum creatinine samples were analysed. The Nanra equation had a bias of -13.4 ml/min/1.73 m while the CKD-EPI equation had bias of 14.2 ml/min/1.73 m. Both equations showed a high degree of proportional error and had poor agreement with 24 h urine creatinine clearance.
CONCLUSIONS
None of the equations were shown to reliably measure the estimated glomerular filtration rate in pregnant women. A valid serum creatinine-based estimated glomerular filtration rate equation in pregnancy is yet to be established.
目的
比较Nanra方程和慢性肾脏病流行病学协作组（CKD-EPI）方程在估算妊娠期肾小球滤过率方面相对于24小时尿肌酐清除率的表现。
方法
孕妇进行24小时尿液收集，同时检测血清肌酐水平。将测量得到的24小时尿肌酐清除率与两个方程（Nanra方程和CKD-EPI方程）进行比较。测量一致性水平，偏差接受范围为±15毫升/分钟/1.73平方米。
结果
共分析了53份同步的尿液和血清肌酐样本。Nanra方程的偏差为-13.4毫升/分钟/1.73平方米，而CKD-EPI方程的偏差为14.2毫升/分钟/1.73平方米。两个方程均显示出高度的比例误差，且与24小时尿肌酐清除率的一致性较差。
结论
没有一个方程被证明能可靠地测量孕妇的估算肾小球滤过率。妊娠期基于血清肌酐的有效估算肾小球滤过率方程尚未建立。
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