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城市社区中患有慢性病的中国患者中功能衰竭风险方程的外部验证
Ling Pan1,2, Jinwei Wang1,3,4, Yang Deng2
1Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.
Kidney medicine
|May 1, 2024
概括
衰竭风险方程准确地预测了中国慢性病患者的衰竭. 这些方程在临床上比单独估计的膜过率在风险评估中更有实用性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 流行病学 流行病学
- 生物统计学 生物统计学
背景情况:
- 衰竭风险方程 (KFRE) 在全球范围内得到验证,但在亚洲人口中缺乏验证.
- 慢性病 (CKD) 影响了中国的大量人口,需要本地化风险预测工具.
研究的目的:
- 在中国CKD队列中对4变量和8变量功能衰竭风险方程进行外部验证.
- 评估模型的歧视性,校准性和临床实用性,用于预测功能衰竭.
主要方法:
- 对慢性病患者的回顾性队列研究 (eGFR < 60 mL/min/1.73 m2).
- 验证4个变量 (年龄,性别,eGFR,白蛋白尿) 和8个变量 (包括血清,酸盐,碳酸盐,白蛋白) 的KFRE模型.
- 使用Harrell的C统计,校准图和决策曲线分析进行评估.
主要成果:
- 两种4和8变量KFRE模型都显示了可接受的歧视 (C统计~0.75-0.77) 和校准.
- 与基于eGFR的策略相比,KFRE模型在5年内预测功能衰竭的临床效用优越.
- 随访持续时间分别为4和8变量模型的4.0年和3.4年.
结论:
- 衰竭风险方程可靠地预测中国CKD患者的衰竭.
- 与传统的基于eGFR的方法相比,KFRE模型提供了更好的临床决策.
- 解决数据的局限性,如白蛋白尿测量,对于更广泛的应用至关重要.
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