在日常护理中,基于肌素,囊素C或两者的GFR估计方程的准确性
Edouard L Fu1,2,3, Andrew S Levey4, Josef Coresh5
1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
概括
估计功能的新方程式,结合肌素和囊素C (eGFRcr-cys),在不同的欧洲人群中表现最好. 这些结合的标记物为在各种并发性疾病中估计膜过率 (eGFR) 的准确性提高.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床化学 临床化学
- 流行病学 流行病学
背景情况:
- 通过CKD-EPI和EKFC开发了新的方程,用于估计使用肌素 (eGFRcr),囊素C (eGFRcys) 或两者 (eGFRcr-cys) 的淋巴球过率 (eGFR).
- 在不同欧洲人群中评估这些方程,特别是那些患有并发症的人群,对于实施至关重要.
研究的目的:
- 评估各种eGFR方程在不同瑞典群体中的表现.
- 为了比较eGFRcr,eGFRcys和eGFRcr-cys方程的精度与测量的GFR (mGFR).
主要方法:
- 这是一项对瑞典斯德哥尔摩6174名成年人进行的横截面研究.
- 同时测量血IOHEXOL清除率 (mGFR),肌素和囊素C.
- 对CKD-EPI (2009/2012/2021),EKFC (2021/2023),RLM (2011) 和CAPA (2014) 方程的性能评估. 这些方程中使用的是:
主要成果:
- eGFRcr-cys方程显示出最小偏差和高精度 (P30接近90%),表现优于 eGFRcr 和 eGFRcys方程.
- 与EKFC和RLM等式相比,CKD-EPI的eGFRcr方程显示出更大的偏差和更低的准确性.
- eGFRcr-cys方程的性能在包括心血管疾病,肝脏疾病,糖尿病和癌症在内的常见并发性疾病中保持稳健.
结论:
- 在这个瑞典队列中,eGFRcr-cys方程是估计功能最准确的,它们之间的变化最小.
- CKD-EPI eGFRcr和其他方程之间的性能差异可能源于种群特征和mGFR方法.
- 实施eGFRc方程需要平衡精度与区域统一性.
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