酶法检测肌酐值估算的肾小球滤过率分析

目的:通过重新表达的MDRD公式(reexpressed modification of diet in renal disease study equation,rMDRD公式),以酶法检测肌酐值估测肾小球滤过率(glomerular filtration rate,GFR),分析rMDRD公式应用于中国慢性肾脏病(chronic kid-ney disease,CKD)患者所得估算的GFR(estimated GFR,eGFR)的精确度及准确性。方法:回顾分析893例CKD患者的临床资料,以同位素法测定的GFR为标准,分析酶法检测肌酐值代入rMDRD公式所得eGFR的精确度及准确性,并评价适当数据转换是否可以提高该公式应用于中国CKD患者的效能。结果:rMDRD公式直接应用于中国CKD患者时精确度和准确性均较低,进行数据转换后,估测效能有所提高,但仍显著低于西方人群。结论:rMDRD公式不适合直接应用于中国CKD患者,亟待开发基于酶法检测肌酐值的eGFR公式。

Estimation of Glomerular Filtration Rate with Enzymatic-assayed Serum Creatinine Values

Objective：To evaluate the performance of the reexpressed modification of diet in renal disease（rMDRD） study equation in estimating glomerular filtration rate（eGFR） from enzymatic-assayed serum creatinine values in Chinese chronic kidney disease（CKD） patients.Methods：Data of 893 Chinese CKD patients were retrospectively collected.The eGFR estimated by rMDRD equation with enzymatic-assayed serum creatinine values in these patients were analyzed,with GFR obtained by isotope scanning as standard.Data transformation was done to improve the performance of the equation.Results： The performance of rMDRD equation in Chinese CKD patients was not satisfying,even if the data was transformed.Conclusions： The rMDRD equation is not good enough for Chinese CKD patients.It is expected to explore an eGFR equation suitable for Chinese CKD patients with enzymatic-assayed serum creatinine values.