评估新型肾小球滤过率估计方程在 1 型糖尿病青少年和年轻成人中的应用。
Evaluation of novel glomerular filtration rate estimation equations in adolescents and young adults with type 1 diabetes.
机构信息
Division of Endocrinology and Metabolism, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Division of Nephrology, Department of Medicine, Queen's University, Kingston, Ontario, Canada.
出版信息
J Diabetes Complications. 2022 Jan;36(1):108081. doi: 10.1016/j.jdiacomp.2021.108081. Epub 2021 Oct 29.
AIMS
Individuals with type 1 diabetes (T1D) are at an increased risk of chronic kidney disease making estimation of glomerular filtration rate (eGFR) an important component of diabetes care. Which eGFR equation is most appropriate to use in patients with T1D during the transition to adult care is unclear. We, therefore, sought to evaluate the performance of five eGFR equations in adolescents and young adults with T1D.
METHODS
Measured iohexol-based glomerular filtration rate was compared to the Chronic Kidney Disease and Epidemiology Collaboration (CKD-EPI) eGFR, Chronic Kidney Disease in Children (CKiD) eGFR, and three recently developed age-adjusted versions of these in 53 patients with T1D and preserved GFR using bias, precision, and accuracy.
RESULTS
The best performance was found in the sex-dependent CKiD equation (bias: -0.8, accuracy: 11.8 ml/min/1.73 m). Bias and accuracy (26.4 and 26.8 ml/min/1.73 m) were worst in the CKD-EPI equation. Age-dependent adjustment improved performance for this equation (bias: 5.3, accuracy: 13.4 ml/min/1.73 m), but not for the CKiD equation (bias: 15.5, accuracy: 18.8 ml/min/1.73 m).
CONCLUSION
Age-adjustment improved performance for the CKD-EPI equation, but not for the CKiD equation. The sex-adjusted CKiD equation performed best out of all equations.
目的
1 型糖尿病（T1D）患者发生慢性肾脏病的风险增加，因此估算肾小球滤过率（eGFR）成为糖尿病治疗的重要组成部分。在向成人护理过渡期间，哪种 eGFR 方程最适合 T1D 患者尚不清楚。因此，我们旨在评估五种 eGFR 方程在 T1D 青少年和年轻人中的表现。
方法
使用偏倚、精度和准确性，将基于 iohexol 的实测肾小球滤过率与慢性肾脏病流行病学合作（CKD-EPI）eGFR、儿童慢性肾脏病（CKiD）eGFR 以及这两种方程的三种最近开发的年龄调整版本进行比较，以评估在 53 名 T1D 患者和保留 GFR 的患者中的表现。
结果
在性别依赖性 CKiD 方程中发现了最佳性能（偏倚：-0.8，准确性：11.8 ml/min/1.73 m）。在 CKD-EPI 方程中，偏倚和准确性（26.4 和 26.8 ml/min/1.73 m）最差。年龄依赖性调整改善了该方程的性能（偏倚：5.3，准确性：13.4 ml/min/1.73 m），但对 CKiD 方程没有改善（偏倚：15.5，准确性：18.8 ml/min/1.73 m）。
结论
年龄调整改善了 CKD-EPI 方程的性能，但没有改善 CKiD 方程的性能。所有方程中，性别调整的 CKiD 方程表现最佳。
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