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在评估肾肿瘤患者保肾手术后前后肾功能时,14 种肾小球滤过率估算公式的适用性。

Applicability of 14 Formulas for Estimating Glomerular Filtration Rate in the Evaluation of Renal Function before and after Nephron-Sparing Surgery in Patients with Renal Tumors.

机构信息

Shengli Clinical Medical College of Fujian Medical University and Department of Urology, Fujian Provincial Hospital, Fuzhou 350001, China.

Medical College, Anhui University of Science and Technology, Huainan 232000, China.

出版信息

Contrast Media Mol Imaging. 2022 May 9;2022:3330442. doi: 10.1155/2022/3330442. eCollection 2022.

Abstract

To compare the applicability of 14 equations of estimating glomerular filtration rate (eGFR) before and after nephron-sparing surgery (NSS) for renal function assessment of patients with renal tumors. Preoperative and postoperative GFR is measured by emission computed tomography (ECT) with 99mTc-DTPA as an imaging agent as reference GFR (rGFR) to compare with all formulas. Spearman correlation analysis and Bland-Altman agreement analysis were used to evaluate the correlation between rGFR and eGFR1 to 14 before and after surgery. A total of 50 cases including 22 males and 28 females were included. The results of preoperative eGFR1-14 correlated with rGFR ( < 0.05). The calculation results of all estimation formulas have a significant correlation with preoperative GFR. Preoperative MDRD-I, CKD-EPI , and FAS have good consistency. The CG formula has the highest precision and FAS has the highest accuracy. A total of 30 patients followed up after surgery, and postoperative rGFR correlated with CG, CKD-EPI, FAS, and BIS formulas ( < 0.05). But postoperative rGFR has no significant correlation with MDRD and Schwartz ( > 0.05). Postoperative CKD-EPI has best consistency, and FAS has the highest accuracy and precision. Our data suggest that eGFR equations evaluated by both serum creatinine (Scr) and cystatin C (SCysC) is not necessarily better than those evaluated by one of them alone. Among all enrolled equations, FAS is the best one to evaluate postoperative GFR in patients with renal tumors.

摘要

比较保肾手术后肾小球滤过率(eGFR)评估患者肾功能的 14 种方程的适用性。术前和术后 GFR 采用发射型计算机断层扫描(ECT)用 99mTc-DTPA 作为成像剂作为参考 GFR(rGFR)与所有公式进行比较。采用 Spearman 相关分析和 Bland-Altman 一致性分析评估手术前后 rGFR 与 eGFR1 至 14 的相关性。共纳入 50 例患者,其中男 22 例,女 28 例。术前 eGFR1-14 与 rGFR 相关(<0.05)。所有估算公式的计算结果与术前 GFR 有显著相关性。术前 MDRD-I、CKD-EPI 和 FAS 具有良好的一致性。CG 公式具有最高的精度,FAS 具有最高的准确性。共 30 例患者术后随访,术后 rGFR 与 CG、CKD-EPI、FAS 和 BIS 公式相关(<0.05)。但术后 rGFR 与 MDRD 和 Schwartz 无显著相关性(>0.05)。术后 CKD-EPI 具有最佳的一致性,FAS 具有最高的准确性和精度。我们的数据表明,通过血清肌酐(Scr)和胱抑素 C(SCysC)评估的 eGFR 方程不一定优于单独通过其中一个评估的方程。在所有纳入的方程中,FAS 是评估肾肿瘤患者术后 GFR 的最佳方程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8e2/9110198/421dcd599108/CMMI2022-3330442.001.jpg

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