在患有慢性病风险的人群中,不同血清肌素检测频率的诊断产量
Marcello Tonelli1, Natasha Wiebe2, Ronald T Gansevoort3
1Department of Medicine, University of Calgary.
Journal of the American Society of Nephrology : JASN
|September 3, 2025
概括
根据年龄和风险因素调整血清肌素检测频率,可以显著减少检测慢性病 (CKD) 所需的检测次数. 这种方法优化了诊断产量,并节约了医疗资源.
科学领域:
- 肝脏病学
- 公共卫生
- 临床诊断
背景情况:
- 目前的指导方针建议对糖尿病或高血压患者进行定期血清肌素检测,以查慢性病 (CKD).
- 然而,这种测试的最佳频率仍未确定.
- 这项研究研究了不同测试频率对发生的CKD的诊断效果.
研究的目的:
- 根据不同测试频率 (每2,3,4或5年) 与年度测试相比,确定发生慢性病的诊断产量.
- 评估年龄,性别,并发症,白蛋白尿和CKD风险评分如何影响血清肌素检测的诊断产量.
主要方法:
- 在加拿大阿尔伯塔省进行了一项以人口为基础的回顾性队列研究,涉及3,515,163名成年人,初步估计的膜过率 (eGFR) 超过60毫升/ 分钟/ 1. 73平方米.
- 该研究评估了各种测试间隔的发生性CKD的诊断产量 (通过≥2个EGFR测量<60毫升/分钟/1.73m2来定义).
- 根据人口因素和临床风险指标进行了分层分析.
主要成果:
- 对于年轻人 (< 50 岁) 来说,与老年人 (> 70 岁) 相比,每年检测出一个新的CKD病例所需的测试数量要大得多.
- 测试频率对不同风险组的诊断产量产生了重大影响,糖尿病,高血压或心力衰竭患者的产量更高.
- 将糖尿病或高血压患者的检测频率降低至每三年一次可以推迟诊断,但每年避免数百万次实验室检测.
结论:
- 血清肌素测试的频率应根据患者的年龄和其他CKD风险因素的存在进行个性化测试.
- 定制测试间隔可以优化发生性CKD的检测,同时减少不必要的实验室利用.
- 这种个性化方法提高了诊断效率,并有可能降低医疗费用.
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