Development and Validation of Creatinine-Based Estimates of the Glomerular Filtration Rate Equation from 99mTc-DTPA Imaging in the Malaysian Setting.

IF 1.7 Q3 UROLOGY & NEPHROLOGY
International Journal of Nephrology Pub Date : 2021-09-08 eCollection Date: 2021-01-01 DOI:10.1155/2021/3465472
Azrina Md Ralib, Farah Nadia Mohd Hanafiah, Iqbalmunawwir Abd Rashid, Mohamad Shahrir Abd Rahim, Fatimah Dzaharudin, Mohd Basri Mat Nor
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引用次数: 0

Abstract

Introduction: Accurate assessment of glomerular filtration rate (GFR) is very important for diagnostic and therapeutic intervention. Clinically, GFR is estimated from plasma creatinine using equations such as Cockcroft-Gault, Modification of Diet in Renal Disease, and Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equations. However, these were developed in the Western population. To the best of our knowledge, there was no equation that has been developed specifically in our population.

Objectives: We developed a new equation based on the gold standard of 99mTc-DTPA imaging measured GFR. We then performed an internal validation by comparing the bias, precision, and accuracy of the new equation and the other equations with the gold standard of 99mTc-DTPA imaging measured GFR.

Methods: This was a cross-sectional study using the existing record of patients who were referred for 99mTc-DTPA imaging at the Nuclear Medicine Centre, International Islamic University Malaysia. As this is a retrospective study utilising routinely collected data from the existing pool of data, the ethical committee has waived the need for informed consent.

Results: Data of 187 patients were analysed from January 2016 to March 2021. Of these, 94 were randomised to the development cohort and 93 to the validation cohort. A new equation of eGFR was determined as 16.637 ∗ 0.9935Age ∗ (SCr/23.473)-0.45159. In the validation cohort, both CKD-EPI and the new equation had the highest correlation to 99mTc-DTPA with a correlation coefficient of 0.81 (p < 0.0001). However, the new equation had the least bias and was the most precise (mean bias of -3.58 ± 12.01) and accurate (P30 of 64.5% and P50 of 84.9%) compared to the other equations.

Conclusion: The new equation which was developed specifically using our local data population was the most accurate and precise, with less bias compared to the other equations. Further study validating this equation in the perioperative and intensive care patients is needed.

Abstract Image

Abstract Image

Abstract Image

基于肌酐估算肾小球滤过率方程的99mTc-DTPA成像在马来西亚的发展和验证。
准确评估肾小球滤过率(glomerular filtration rate, GFR)对诊断和治疗干预具有重要意义。在临床上,GFR是用Cockcroft-Gault、肾脏疾病患者饮食改变和慢性肾脏疾病-流行病学合作(CKD-EPI)方程等公式从血浆肌酐来估计的。然而,这些都是在西方人群中发展起来的。据我们所知,并没有专门针对我们的人口发展出这样的等式。目的:基于99mTc-DTPA成像测量GFR的金标准,我们建立了一个新的方程。然后,我们通过比较新方程和其他方程与99mTc-DTPA成像测量GFR的金标准的偏差,精度和准确性进行内部验证。方法:这是一项横断面研究,使用在马来西亚国际伊斯兰大学核医学中心转诊进行99mTc-DTPA成像的现有患者记录。由于这是一项回顾性研究,利用了从现有数据池中常规收集的数据,伦理委员会已经放弃了知情同意的需要。结果:分析了2016年1月至2021年3月187例患者的数据。其中,94人被随机分配到开发队列,93人被随机分配到验证队列。新的eGFR方程为16.637∗0.9935Age∗(SCr/23.473)-0.45159。在验证队列中,CKD-EPI和新方程与99mTc-DTPA的相关性最高,相关系数为0.81 (p < 0.0001)。然而,与其他方程相比,新方程偏差最小,精度最高(平均偏差为-3.58±12.01),准确性最高(P30为64.5%,P50为84.9%)。结论:与其他方程相比,专门利用我们的本地数据人群开发的新方程是最准确和精确的,偏差较小。需要进一步的研究在围手术期和重症监护患者中验证这一方程。
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来源期刊
International Journal of Nephrology
International Journal of Nephrology UROLOGY & NEPHROLOGY-
CiteScore
3.40
自引率
4.80%
发文量
44
审稿时长
17 weeks
期刊介绍: International Journal of Nephrology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies focusing on the prevention, diagnosis, and management of kidney diseases and associated disorders. The journal welcomes submissions related to cell biology, developmental biology, genetics, immunology, pathology, pathophysiology of renal disease and progression, clinical nephrology, dialysis, and transplantation.
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