Azrina Md Ralib, Farah Nadia Mohd Hanafiah, Iqbalmunawwir Abd Rashid, Mohamad Shahrir Abd Rahim, Fatimah Dzaharudin, Mohd Basri Mat Nor
{"title":"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。","authors":"Azrina Md Ralib, Farah Nadia Mohd Hanafiah, Iqbalmunawwir Abd Rashid, Mohamad Shahrir Abd Rahim, Fatimah Dzaharudin, Mohd Basri Mat Nor","doi":"10.1155/2021/3465472","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Objectives: </strong>We developed a new equation based on the gold standard of <sup>99m</sup>Tc-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 <sup>99m</sup>Tc-DTPA imaging measured GFR.</p><p><strong>Methods: </strong>This was a cross-sectional study using the existing record of patients who were referred for <sup>99m</sup>Tc-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.</p><p><strong>Results: </strong>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 ∗ 0.9935<sup>Age</sup> ∗ (SCr/23.473)<sup>-0.45159</sup>. In the validation cohort, both CKD-EPI and the new equation had the highest correlation to <sup>99m</sup>Tc-DTPA with a correlation coefficient of 0.81 (<i>p</i> < 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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2021 ","pages":"3465472"},"PeriodicalIF":1.7000,"publicationDate":"2021-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8443382/pdf/","citationCount":"0","resultStr":"{\"title\":\"Development and Validation of Creatinine-Based Estimates of the Glomerular Filtration Rate Equation from <sup>99m</sup>Tc-DTPA Imaging in the Malaysian Setting.\",\"authors\":\"Azrina Md Ralib, Farah Nadia Mohd Hanafiah, Iqbalmunawwir Abd Rashid, Mohamad Shahrir Abd Rahim, Fatimah Dzaharudin, Mohd Basri Mat Nor\",\"doi\":\"10.1155/2021/3465472\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>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.</p><p><strong>Objectives: </strong>We developed a new equation based on the gold standard of <sup>99m</sup>Tc-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 <sup>99m</sup>Tc-DTPA imaging measured GFR.</p><p><strong>Methods: </strong>This was a cross-sectional study using the existing record of patients who were referred for <sup>99m</sup>Tc-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.</p><p><strong>Results: </strong>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 ∗ 0.9935<sup>Age</sup> ∗ (SCr/23.473)<sup>-0.45159</sup>. In the validation cohort, both CKD-EPI and the new equation had the highest correlation to <sup>99m</sup>Tc-DTPA with a correlation coefficient of 0.81 (<i>p</i> < 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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":14177,\"journal\":{\"name\":\"International Journal of Nephrology\",\"volume\":\"2021 \",\"pages\":\"3465472\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2021-09-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8443382/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Nephrology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1155/2021/3465472\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Nephrology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2021/3465472","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Development and Validation of Creatinine-Based Estimates of the Glomerular Filtration Rate Equation from 99mTc-DTPA Imaging in the Malaysian Setting.
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.
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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