2021 年慢性肾脏病流行病学合作组、全年龄谱和欧洲肾脏功能联盟方程评估在 2 型糖尿病和健康成年人中估算肾小球滤过率的准确性。

Accuracy evaluation of 2021 Chronic Kidney Disease Epidemiology Collaboration, Full Age Spectrum and European Kidney Function Consortium equations for estimating glomerular filtration rate in type 2 diabetes mellitus and healthy adults.

机构信息

Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Endocrine Unit, Hospital de Clínicas de Porto Alegre (HCPA), Brazil.

出版信息

Clin Chim Acta. 2022 Sep 1;534:14-21. doi: 10.1016/j.cca.2022.06.025. Epub 2022 Jul 2.

DOI:10.1016/j.cca.2022.06.025

PMID:35792160

Abstract

BACKGROUND AND AIMS

Estimated glomerular filtration rate (eGFR) equations accuracy has been questioned in diabetes mellitus (DM). We aimed to evaluate the performance of three equations - European Kidney Function Consortium (EKFC), Full Age Spectrum (FAS), and 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) - in healthy and type 2 DM participants.

MATERIAL AND METHODS

This cross-sectional studycompared eGFR equations withareference method: measured GFR (mGFR) by Cr-EDTA. The equations performance was assessed usingBland-Altman plot,concordance correlation coefficient (CCC), bias,P30 andP15 accuracy.

RESULTS

In the 100 healthy adults included (aged 39 ± 15 years, 67% women, mean mGFR 107 ± 15, 2021 CKD-EPI 109 ± 14, FAS 107 ± 18 and EKFC 101 ± 12 mL/min/1.73 m), all equations reached P30 accuracy above the desirable benchmark of 90%. In the 122 patients with type 2 DM (aged 61 ± 10 years, 55% women, mGFR97 ± 22, 2021 CKD-EPI 86 ± 20, FAS 83 ± 25 and EKFC 79 ± 18 mL/min/1.73 m), the equations presented larger biases, worst agreement with mGFR and inferior accuracy, with 2021 CKD-EPI (83%) and EKFC (82%) presenting greater P30 than FAS (77%).

CONCLUSION

In healthy Brazilian adults, 2021 CKD-EPI, FAS and EKFC are suitable to estimate GFR. However, all equations underperform in people with type 2 DM.

摘要

背景和目的

肾小球滤过率（eGFR）的估算公式在糖尿病（DM）患者中的准确性受到质疑。我们旨在评估三个公式——欧洲肾脏功能联盟（EKFC）、全年龄谱（FAS）和 2021 年慢性肾脏病流行病学合作（CKD-EPI）——在健康人和 2 型糖尿病患者中的表现。

材料和方法

这项横断面研究将 eGFR 公式与参考方法（通过 Cr-EDTA 测量的 GFR（mGFR））进行了比较。使用 Bland-Altman 图、一致性相关系数（CCC）、偏差、P30 和 P15 准确性来评估公式的性能。

结果

在纳入的 100 名健康成年人中（年龄 39±15 岁，67%为女性，平均 mGFR 为 107±15，2021 年 CKD-EPI 为 109±14，FAS 为 107±18，EKFC 为 101±12 mL/min/1.73 m），所有公式的 P30 准确性均达到了 90%以上的理想基准。在 122 名 2 型糖尿病患者中（年龄 61±10 岁，55%为女性，mGFR 为 97±22，2021 年 CKD-EPI 为 86±20，FAS 为 83±25，EKFC 为 79±18 mL/min/1.73 m），这些公式的偏差较大，与 mGFR 的一致性较差，准确性也较低，其中 2021 年 CKD-EPI（83%）和 EKFC（82%）的 P30 大于 FAS（77%）。