Eisinger Felix, Neumann Mareike, Wörn Matthias, Fritsche Andreas, Heyne Nils, Peter Andreas, Birkenfeld Andreas L, von Schwartzenberg Reiner Jumpertz, Artunc Ferruh
Department of Diabetology, Endocrinology, Nephrology, University of Tuebingen, Tuebingen, Germany.
Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tuebingen, Tuebingen, Germany.
J Nephrol. 2025 Mar;38(2):707-716. doi: 10.1007/s40620-024-02202-4. Epub 2025 Jan 10.
The estimation of glomerular filtration rate (eGFR) is essential in the early detection of diabetic nephropathy. We herein compare the performance of common eGFR formulas against a gold standard measurement of GFR in patients with diabetes mellitus.
GFR was measured in 93 patients with diabetes mellitus using iohexol clearance as the reference standard. The performance of the creatinine- and cystatin C-based EKFC formulas (2021, 2023) and the CKD-EPI formulas (2009, 2012) was compared against measured GFR.
Sixty patients with type 2 diabetes mellitus and 33 patients with type 1 diabetes mellitus were included. The creatinine-based EKFC formula showed lower bias and higher accuracy than the CKD-EPI formula. No significant difference was observed between the cystatin C-based formulas. The combined creatinine- and cystatin C-based formulas had the highest accuracy and lowest bias. Body fat or diabetes type did not significantly influence the accuracy of the cystatin C-based formulas.
Our study demonstrated a slight advantage of the creatinine-based EKFC formula over the CKD-EPI formula in patients with diabetes. However, both for the CKD-EPI and the EKFC formula, the best performance was achieved by the combined creatinine- and cystatin C-based formulas.
肾小球滤过率（eGFR）的估算对于糖尿病肾病的早期检测至关重要。我们在此比较常用的eGFR公式在糖尿病患者中相对于GFR金标准测量方法的性能。
对93例糖尿病患者采用碘海醇清除率作为参考标准测量GFR。将基于肌酐和胱抑素C的EKFC公式（2021年、2023年）以及CKD-EPI公式（2009年、2012年）的性能与测量的GFR进行比较。
纳入60例2型糖尿病患者和33例1型糖尿病患者。基于肌酐的EKFC公式比CKD-EPI公式显示出更低的偏差和更高的准确性。基于胱抑素C的公式之间未观察到显著差异。基于肌酐和胱抑素C的联合公式具有最高的准确性和最低的偏差。体脂或糖尿病类型对基于胱抑素C的公式的准确性没有显著影响。
我们的研究表明，在糖尿病患者中，基于肌酐的EKFC公式相对于CKD-EPI公式有轻微优势。然而，对于CKD-EPI公式和EKFC公式，基于肌酐和胱抑素C的联合公式表现最佳。
