3种CKD-EPI方程估算肾小球滤过率的比较

目的：评价联合肌酐和胱抑素C的慢性肾脏病流行病合作工作组( CKD-EPI)方程( CKD-EPIscr-cys方程)是否比单独基于血肌酐和单独基于胱抑素C的CKD-EPI方程(分别为CKD-EPIscr方程、CKD-EPIcys方程)更适合估算合肥地区慢性肾脏病( CKD )患者肾小球滤过率( GFR )。方法收集CKD患者的人口学特征、临床资料、血胱抑素C值、血浆肌酐值和99 m Tc-DTPA肾动态显像资料,以99 m Tc-DTPA肾动态显像法所测 GFR 为金标准,分别用 CKD-EPIscr方程、CKD-EPIcys方程和CKD-EPIscr-cys方程估算CKD患者GFR,比较3种方程估计偏差、精确性、准确性和估计值与标准值间的95%一致性。结果与 CKD-EPIscr方程相比, CKD-EPIscr-cys方程估计偏差无改善,精确度、30%和50%准确性、95%一致性均提高；与CKD-EPIcys方程相比,CKD-EPIscr-cys方程降低了偏差,提高了精确度、15%和30%准确性、95%一致性。结论 CKD-EPIscr-cys方程可能比单独基于肌酐和单独基于胱抑素C的CKD-EPI方程更适用于评估合肥地区CKD患者GFR。

Comparisons among three CKD-EPI equations for estimation of glomerular filtration rate

Objective To evaluate whether the combined creatinine-cystatin C chronic kidney disease-epidemiology collaboration ( CKD-EPI) equation ( CKD-EPIscr-cys equation) could perform better than the CKD-EPI equation based on creatinine alone ( CKD-EPIscr equation) and the CKD-EPI equation based on cystatin C alone ( CKD-EPIcys equation) in estimating glomerular filtration rate ( GFR) in patients with chronic kidney disease ( CKD) from Hefei city. Methods Demographic, clinical characteristics, serum creatinine and serum cystatin C of CKD pa-tients were collected. GFR measured by dynamic renal imaging with 99m Tc-DTPA was used as the gold standard of GFR. GFR was estimated by CKD-EPIscr equation, CKD-EPIcys equation and CKD-EPIscr-cys equation. The bias, ac-curacy, precision and agreement were compared between CKD-EPIscr-cys equation and another two equations. Results Compared with CKD-EPIscr equation, CKD-EPIscr-cys equation had better agreement and greater 15% and 30% ac-curacy with the measured GFR;compared with CKD-EPIcys equation, CKD-EPIscr-cys equation had lower bias, better agreement and greater 30% and 50% accuracy. Conclusion The CKD-EPIscr-cys equation may be more suitable for estimation of GFR in patients with CKD from Hefei city.