在住院的老年人中,小组估计的GFR的表现
Esben Iversen1, Anne Kathrine Bengaard2, Aino Leegaard Andersen1
1Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre.
概括
在老年人中估计功能对于安全的药物剂量至关重要. 结合肌素和细胞素C的方程 (CKD-EPI_comb) 证明了高精度估计质过率 (GFR).
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 老年病的医生 老年病的医生
- 临床药理学 临床药理学
背景情况:
- 老年人容易因功能受损而导致药物错误.
- 精确估计膜过率 (GFR) 对于在这个人群中适当的药物剂量至关重要.
- 现有的GFR估计方程可能不会在老年人中发挥最佳作用,特别是那些包含多个过标志物的方程.
研究的目的:
- 评估用于估计住院老年人GFR的各种方程的性能.
- 为了比较基于肌素,肌素-囊素C组合和多标志物面板方程与测量的GFR (mGFR).
- 为了确定这个脆弱的患者群体最准确的GFR估计方程.
主要方法:
- 一个横截面诊断测试子研究,涉及106名65岁及以上的住院成年人.
- 使用99mTc-DTPA血清除率作为参考标准测量GFR (mGFR).
- 使用偏差,不准确性 (1-P30) 和RMSE,对10种不同的估计GFR (eGFR) 方程 (基于肌素,肌素-囊素C组合,多标记面板) 的性能进行比较.
主要成果:
- 2021年CKD-EPI_comb方程 (肌素和细胞素C) 在组合标记方程中表现最好,相对偏差低 (-3.4%),不准确 (3.8%) 和RMSE (0.139).
- 基于肌素的方程,特别是2009年CKD-EPI_cr,在他们的组中相对偏差最小 (+4.2%).
- 多标记面板方程 (CKD-EPI_面板) 与CKD-EPI_comb相比提供了最小的改进,RMSE略小,但不准确性更高.
结论:
- 结合肌素和细胞素C的方程 (例如,2021 CKD-EPI_comb) 提供了老年人准确的GFR估计.
- 与单独的肌氨酸相比,添加囊素C显著改善了GFR估计.
- 进一步添加BTP和B2M等标记器提供了有限的额外准确性好处.
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