Di Gioia Giuseppe, Ferrera Armando, Serdoz Andrea, Spinelli Alessandro, Fiore Roberto, Buzzelli Lorenzo, Zampaglione Domenico, Squeo Maria Rosaria
Institute of Sports Medicine and Science, National Italian Olympic Committee, Largo Piero Gabrielli, 1, 00197 Rome, Italy.
Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro De Bosis, 15, 00135 Rome, Italy.
J Clin Med. 2025 Apr 24;14(9):2955. doi: 10.3390/jcm14092955.
Various creatinine-based equations are used to estimate the glomerular filtration rate (eGFR) in athletes, but each has limitations. The aim of our study was to identify the most suitable formula for use in athletes. We evaluated 490 Olympic athletes (27 ± 5.3 yo) with normal values of serum creatinine and no history of kidney diseases. Athletes were divided into those practicing skills and endurance disciplines. The EGFR was calculated with Cockcroft-Gault (CG), MDRD, MCQE and CKD-EPI, and classified as stages G1-G5 according to the Kidney Disease Improving Global Outcomes (KDIGO) GFR categories. Endurance athletes showed higher serum creatinine (0.91 ± 0.14 mg/dL vs. 0.88 ± 0.13 mg/dL in skills, = 0.014). The eGFR calculated with the CKD-EPI and MCQE formulas showed no differences between the groups. The CG formula produced a lower eGFR for endurance athletes (113.6 ± 27 mL/min/1.73 m) compared to skills athletes (122.6 ± 30.8, = 0.008), while MDRD produced higher values for endurance athletes (129.3 ± 25.8 vs. 122.6 ± 24 mL/min/1.73 m, = 0.004). According to CKD-EPI, all athletes were in G1, while with MCQE, 0.5% of skills athletes and 1% of endurance athletes were in G2. With the CG formula, a significant percentage of athletes were in G2 (13.2% of skills athletes and 18.5% of endurance athletes, = 0.125). With the MDRD formula, 29 athletes (5.9%) were in G2 (6% for skills athletes and 5.8% for endurance athletes, = 0.927). CKD-EPI and MCQE showed better stability and reliability, making them the most suitable for kidney function evaluation in athletes.
各种基于肌酐的公式被用于估算运动员的肾小球滤过率（eGFR），但每种公式都有局限性。我们研究的目的是确定最适合运动员使用的公式。我们评估了490名血清肌酐值正常且无肾脏疾病史的奥运会运动员（27±5.3岁）。运动员被分为从事技巧类和耐力类项目的两组。使用Cockcroft-Gault（CG）、MDRD、MCQE和CKD-EPI公式计算eGFR，并根据改善全球肾脏病预后组织（KDIGO）的GFR分类标准分为G1-G5期。耐力项目运动员的血清肌酐水平较高（0.91±0.14mg/dL，技巧类项目运动员为0.88±0.13mg/dL，P=0.014）。用CKD-EPI和MCQE公式计算的eGFR在两组之间没有差异。与技巧类项目运动员相比，CG公式计算出的耐力项目运动员的eGFR较低（113.6±27mL/min/1.73m²，技巧类项目运动员为122.6±30.8，P=0.008），而MDRD公式计算出的耐力项目运动员的eGFR较高（129.3±25.8，技巧类项目运动员为122.6±24mL/min/1.73m²，P=0.004）。根据CKD-EPI公式，所有运动员都处于G1期，而按照MCQE公式，0.5%的技巧类项目运动员和1%的耐力项目运动员处于G2期。使用CG公式时，有相当比例的运动员处于G2期（13.2%的技巧类项目运动员和18.5%的耐力项目运动员，P=0.125）。使用MDRD公式时，有29名运动员（5.9%）处于G2期（技巧类项目运动员为6%，耐力项目运动员为5.8%，P=0.927）。CKD-EPI和MCQE表现出更好的稳定性和可靠性，使其最适合用于评估运动员的肾功能。
