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Physiology Lab Demonstration: Glomerular Filtration Rate in a Rat
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在南巴西人中,是否需要进行种族调整来估计球膜过率?
Gustavo Monteiro Escott1,2, Carolina Pires Zingano3,4, Elton Ferlin4
1Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2º andar, Porto Alegre, RS, 90035-003, Brazil. gustavo.escott@gmail.com.
Journal of nephrology
|June 24, 2024
概括
2021年CKD-EPI方程式並不能改善巴西人的膠質球膜過濾率 (GFR) 估計,並可能低估白人慢性腎臟病 (CKD) 的診斷. 因此,2009年CKD-EPI仍被推用于巴西人口.
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:
- 估计的膜过率 (eGFR) 方程中的种族系数存在争议.
- 以前用于GFR估计的方程在不同种族群体的准确性方面面临着严格的审查.
研究的目的:
- 评估2009年CKD-EPI,2021年CKD-EPI和EKFC方程的性能,用于估计自报告的黑人和白人巴西人的GFR.
- 为了比较这些eGFR方程与测量的GFR (mGFR) 的准确性.
主要方法:
- 一项涉及健康成年人,2型糖尿病患者和慢性病 (CKD) 患者的横截面研究.
- 从三个方程 (2009年CKD-EPI,2021年CKD-EPI,EKFC) 的eGFR与Cr-EDTA mGFR进行比较.
- 使用布兰德-阿尔特曼图表,林的一致性相关系数 (CCC),偏差和P30/P15精度进行性能评估.
主要成果:
- 在白人和黑人参与者中,没有任何测试方程达到所需的P30精度 (≥90%).
- 2009年的CKD-EPI在黑人参与者中表现更好 (偏见:4.04,CCC:0.848),而2021年的CKD-EPI在白人参与者中表现更好 (偏见:1.45,CCC:0.790).
- 所有方程都在白人参与者中低诊断了晚期CKD,但在黑人参与者中没有. 在EKFC方程中,表现最差.
结论:
- 2021年CKD-EPI方程与巴西人口的2009年CKD-EPI相比,没有提供更好的GFR估计.
- 2021年CKD-EPI可能导致白种巴西人的CKD诊断不足.
- 该研究建议不要将2009年的CKD-EPI用2021年的CKD-EPI替换为巴西的GFR估计.
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