新旧的GFR方程:一个欧洲的视角
Pierre Delanaye1,2, Etienne Cavalier3, Hans Pottel4
1Department of Nephrology-Dialysis-Transplantation, University of Liège, CHU Sart Tilman, Liège, Belgium.
Clinical kidney journal
|September 4, 2023
概括
新的功能方程,欧洲功能联盟 (EKFC) 方程,在不同人群中提供了更好的估计球过率 (eGFR) 精度,解决了以前基于肌素的模型的局限性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床化学 临床化学
- 生物标志物开发 生物标志物开发
背景情况:
- 估计淋巴膜过率 (GFR) 对于诊断和治疗病至关重要.
- 目前基于肌素的方程,如CKD-EPI2009和CKD-EPIcr2021,具有显著的局限性,包括与年龄相关的高估和种族/种族偏见.
- 对CKD-EPIcr2021的重新校准并没有解决不同人群的性能问题.
研究的目的:
- 与CKD-EPI方程相比,评估欧洲功能联盟 (EKFC) 基于肌素的方程 (EKFC) 和基于囊素C的方程 (EKFC_CC) 的性能.
- 评估EKFC方程在儿童和成人护理过渡期间提供连续GFR估计的能力.
- 为了确定 EKFC 方程在不同种族和民族群体中的准确性.
主要方法:
- 对 GFR 估计方程的比较分析:CKD-EPI2009,CKD-EPIcr2021,EKFC 和 EKFC_CC.
- 评估不同年龄组的方程表现,特别是从儿科到成人护理的过渡.
- 在各种种族和族裔群体中评估方程准确性,包括白人欧洲人,黑人欧洲人和黑人非洲人.
主要成果:
- CKD-EPI方程式,包括重新校准的CKD-EPIcr2021,在年轻人中显示出明显的高估,并表现出种族/民族偏见.
- EKFC方程显示,eGFR估计的性能和连续性有所改善,特别是在儿科-成人过渡时.
- 由于 EKFC_CC 方程不涉及性别和种族,其表现优于 CKD-EPI 囊素 C 方程,并显示出公平的 GFR 估计的前景.
结论:
- EKFC方程式代表了GFR估计的重大进步,解决了现有的CKD-EPI模型的关键局限性.
- EKFC 方程为不同人群和年龄组提供更准确和公平的 GFR 估计.
- 尽管有所改善,但对于特定的临床场景,通过外源清除精确测量GFR仍然是必要的.
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