三种肾小球滤过率估算公式与 24 小时尿液肌酐清除率测量在潜在活体肾脏捐献者中的比较

IF 1.7 Q3 UROLOGY & NEPHROLOGY
International Journal of Nephrology Pub Date : 2023-06-15 eCollection Date: 2023-01-01 DOI:10.1155/2023/2022641
Fernando Giron-Luque, Andrea Garcia-Lopez, Yenny Baez-Suarez, Nasly Patino-Jaramillo
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引用次数: 0

摘要

背景:潜在活体肾脏捐献者(PLKD)肾功能测量的准确性至关重要。直接测量肾小球滤过率(mGFR)一直被认为是 "黄金标准"。估算的肾小球滤过率(eGFR)和 24 小时尿肌酐清除率(CrCl)因其可用性而经常被使用。我们旨在评估使用基于血清的肌酐公式(Cockcroft-Gault、MDRD 和 CKD-EPI)计算的 eGFR 与基于 24 小时尿液 CrCl 的 eGFR 在评估 PLKD 肾功能时的相关性和一致性:我们使用 24 小时尿 CrCl 法评估了 799 例 PLKD 的肾功能,并比较了与基于肌酐公式(Cockcroft-Gault、MDRD 和 CKD-EPI)的 eGFR 的相关性和一致性。我们计算了平均偏差(差值)、精确度(差值的 SD 值)和准确度,并绘制了 Bland-Altman 图:结果:共分析了 799 例 PLKD。PLKD的年龄从18岁到73岁不等。观察发现,24 小时尿 CrCl 与所有公式之间存在微弱至轻度的相关性(从 0.31 到 0.49 不等)。三种公式都低估了肾小球滤过率。通过使用 Bland-Altman 图形,我们观察到 CKD-EPI 的分散性最小且最精确;然而,所有公式的平均偏差和间隔范围(一致性限制)都过大,因此无法假设 24 小时尿 CrCl 方法与基于肌酐的 eGFR 之间具有等效性。在比较 CrCl GFR 患者的三种公式时,平均偏差结果相似:在该 PLKD 队列中,在所有三种方程中,CKD-EPI 的偏差最小且最精确。但是,这三种方程与 24 小时尿 CrCl 之间的相关性和一致程度太低,因此不能假定其等效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Comparison of Three Glomerular Filtration Rate Estimating Equations with 24-Hour Urine Creatinine Clearance Measurement in Potential Living Kidney Donors.

Comparison of Three Glomerular Filtration Rate Estimating Equations with 24-Hour Urine Creatinine Clearance Measurement in Potential Living Kidney Donors.

Background: The accuracy of the measurement of renal function in potential living kidney donors (PLKD) is essential. The direct measurement of glomerular filtration rate (mGFR) has been considered the "gold standard." The estimated GFR (eGFR) with 24-hour urinary creatinine clearance (CrCl) is frequently used because of its availability. We aim to evaluate the correlation and agreement of eGFR using serum-based creatinine formulas (Cockcroft-Gault, MDRD, and CKD-EPI) and the eGFR based on 24-hour urinary CrCl to evaluate kidney function in PLKD.

Methods: We evaluated the kidney function in 799 PLKD using 24-hour urinary CrCl method and compared the correlation and agreement with the eGFR based on creatinine formulas (Cockcroft-Gault, MDRD, and CKD-EPI). We calculated the mean bias (difference), precision (SD of this difference), accuracy, and performed Bland-Altman plots.

Results: A total of 799 PLKD were analyzed. The age of the PLKD ranged from 18 to 73 years. Weak to mild correlation was observed between 24-hour urinary CrCl and all formulas (ranged from 0.31 to 0.49). The three equations underestimated the GFR. Using the Bland-Altman graphic, we observed that the CKD-EPI was the least scattered and most precise; however, mean bias and the interval range (limits of agreement) of all formulas were too big to assume equivalence between 24-hour urinary CrCl method and eGFR based on creatinine. Results of mean bias were similar when comparing the three equations in patients with CrCl GFR <60. However, the accuracy of all formulas was better for the female group and the youngest individuals (≤40 years old).

Conclusion: In this PLKD cohort, of all the three equations, the CKD-EPI was the least scattered and most precise. However, the correlation and the level of agreement between the three equations and 24-hour urinary CrCl were too low to assume the equivalence.

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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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