图卢兹 - 兰eGFR12预测模型在活体捐赠者切除术后的外部验证
Suhani S Patel1, Bonnie E Lonze1, Teresa Po-Yu Chiang1
1Department of Surgery, Transplant Institute, NYU Langone Health, New York, NY, United States.
概括
图卢兹-兰尔模型高估了美国活着的脏捐赠者的功能. 这种模型对男性,黑人捐赠者和年轻人来说不太准确,这表明需要一种新的预测方程.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 移植 移植 移植 移植
- 公共卫生 公共卫生
背景情况:
- 捐赠后估计膜过率 (eGFR) 降低与活体脏捐赠者末期脏病 (ESRD) 风险增加相关.
- 图卢兹-朗威尔模型 (TRM) 预测捐赠后12个月的eGFR (eGFR12),以帮助捐赠者咨询.
- 以前的TRM验证仅限于欧洲队列.
研究的目的:
- 为了验证TRM在估计美国活着的脏捐赠者中捐赠后eGFR的准确性.
- 评估不同人口群体的TRM预测中的潜在偏差.
主要方法:
- 从2000年1月至2021年6月的美国移植受体科学注册表 (SRTR) 的数据使用.
- 将观察到的eGFR12 (使用2021年CKD-EPI方程) 与TRM预测的eGFR12进行比较.
- 使用2009年CKD-EPI方程进行了敏感性分析.
主要成果:
- 在美国捐赠者中,TRM显示了3.4mL/min/1.73m2的中位偏差,这表明功能被高估了.
- 偏见在男性,年轻的捐赠者 (31-40岁) 和黑人捐赠者中比同行更为明显.
- 预测和观察到的eGFR12之间的整体相关性为0.71.
结论:
- TRM高估了美国活着的脏捐赠者群体中捐赠后的功能.
- 该模型的高估值在患捐后ESRD风险较高的人群中最大,包括男性,黑人个人和年轻的捐赠者.
- 对于准确的捐赠后EGFR估计,需要修订或新的预测方程,用于美国活着的脏捐赠者.
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