评估欧洲实验室在评估慢性肾脏病（CKD）生物标志物方面的现状及改进建议：来自 2022 年 EFLM 慢性肾脏病工作组调查的见解。
Assessing the status of European laboratories in evaluating biomarkers for chronic kidney diseases (CKD) and recommendations for improvement: insights from the 2022 EFLM Task Group on CKD survey.
机构信息
Department of Clinical Chemistry, University of Liege, CIRM, CHU de Liège, Liège, Belgium.
Department of Clinical Biochemistry, KAT General Hospital, Athens, Greece.
出版信息
Clin Chem Lab Med. 2023 Oct 2;62(2):253-261. doi: 10.1515/cclm-2023-0987. Print 2024 Jan 26.
OBJECTIVES
Chronic kidney disease (CKD) is a global health issue, ranking as the third leading cause of death worldwide. CKD diagnosis and management depend on clinical laboratory tests, necessitating consistency for precise patient care. Global harmonization of CKD testing through clinical practice guidelines (CPGs) is recommended. Prior to CPG development, assessing the current CKD testing landscape is crucial. In 2022, the European Federation of Laboratory Medicine (EFLM) conducted an online survey among European laboratories associated with EFLM, evaluating CKD testing practices, including new glomerular filtration rate (GFR) estimation methods. This report summarizes the 2022 survey findings and offers recommendations for improving CKD test standardization.
METHODS
An online survey was conducted in November 2022 using a questionnaire hosted on LimeSurvey sent to European laboratories affiliated with the EFLM. The survey results were recorded in Excel files and analysed.
RESULTS
The results highlight significant discrepancies among countries in unit expression, methods, cystatin C use, and GFR calculation equations. Additionally, limited attention to pediatric renal biology specifics, varied proteinuria and albuminuria result expressions, and limited awareness of GFR measurement methods through iohexol clearance are noted.
CONCLUSIONS
In an effort to enhance the standardization of crucial biomarkers utilized in nephrology for evaluating renal function and diagnosing kidney injuries, the EFLM Task Group on CKD suggests nine practical recommendations tailored for European laboratories. The group is confident that implementing these measures will minimize result expression discrepancies, ultimately leading to enhanced patient care.
目的
慢性肾脏病（CKD）是一个全球性的健康问题，是全球范围内的第三大致死原因。CKD 的诊断和管理依赖于临床实验室检测，这就需要为了精确的患者护理而保持一致性。建议通过临床实践指南（CPG）实现 CKD 检测的全球协调。在制定 CPG 之前，评估当前 CKD 检测现状至关重要。2022 年，欧洲临床化学和检验医学联合会（EFLM）对与 EFLM 相关的欧洲实验室进行了一项在线调查，评估了 CKD 检测实践，包括新的肾小球滤过率（GFR）估计方法。本报告总结了 2022 年的调查结果，并提出了改善 CKD 检测标准化的建议。
方法
2022 年 11 月，通过 LimeSurvey 托管的问卷在网上进行了一项调查，该问卷被发送到与 EFLM 有关的欧洲实验室。将调查结果记录在 Excel 文件中并进行分析。
结果
结果突出显示了各国在单位表达、方法、胱抑素 C 应用和 GFR 计算方程方面存在显著差异。此外，还注意到对儿科肾脏生物学细节的关注有限、蛋白尿和白蛋白尿结果表达的差异以及对 GFR 测量方法（通过碘海醇清除率）的认识有限。
结论
为了加强在评估肾功能和诊断肾脏损伤方面用于肾病学的关键生物标志物的标准化，EFLM CKD 工作组提出了针对欧洲实验室的九条实用建议。工作组相信，实施这些措施将最大限度地减少结果表达差异，最终改善患者护理。
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