较低eGFR患病率和使用2009年和2021年CKD-EPI方程预测墨西哥成年人的死亡率的比较
Daniel Ramírez-García1,2, Carlos A Fermín-Martínez1,3, Paulina Sánchez Castro1,2
1Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico.
Clinical journal of the American Society of Nephrology : CJASN
|December 12, 2025
概括
2021年CKD-EPI方程式估计墨西哥慢性病患病率较低,与2009年版本相比. 这种更新的方程提供了与预后相关的重新分类,而不会影响病监测的实用性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 精确估计膜过率 (eGFR) 对于慢性病 (CKD) 管理至关重要.
- 2021年CKD-EPI方程式更新了2009年版本,删除了种族系数,需要在不同人群中进行评估.
- 关于CKD-EPI 2021方程对eGFR估计的影响及其对墨西哥人口的预后影响尚不清楚.
研究的目的:
- 为了比较墨西哥2009年和2021年的CKD-EPI方程之间的eGFR类别流行率和预测性能.
- 在墨西哥人中使用CKD-EPI 2021方程评估eGFR类别重新分类的预后相关性.
- 评估对识别低eGFR的个体的影响.
主要方法:
- 来自墨西哥国家健康和营养调查 (ENSANUT) 的25,110名成年人对eGFR患病率的分析.
- 来自墨西哥城前性研究 (MCPS) 的142,884名成年人对死亡风险的评估.
- 利用考克斯的比例危险和Fine和Gray回归模型来分析死亡风险和重新分类影响.
主要成果:
- 在CKD-EPI 2021方程式中,与ENSANUT.的2009方程式 (4%) 相比,EGFR<60mL/min/1.73m2 (3%) 的流行率较低.
- 使用2021年方程的7%的成年人出现了向上的eGFR重新分类,特别是在老年人和患有高血压或糖尿病的人群中.
- 在MCPS中,通过2021年方程将其重新分类到更高的eGFR类别与所有原因,心血管和相关死亡率的风险降低有关.
结论:
- 根据CKD-EPI 2021方程,墨西哥的低eGFR患病率较低.
- 与2009年方程相比,2021年的方程提供了与2009年方程相比具有预后意义的eGFR类别重新分类.
- 支持实施CKD-EPI 2021方程,用于墨西哥人口健康监测,而不会损失预后效用.
相关概念视频
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
171
Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area.
171
01:28Chronic Kidney Disease III: Interprofessional Care
320
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
320
01:25Chronic Kidney Disease I: Introduction
541
Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
541
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
217
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
217
01:24Kaplan-Meier Approach
536
The Kaplan-Meier estimator is a non-parametric method used to estimate the survival function from time-to-event data. In medical research, it is frequently employed to measure the proportion of patients surviving for a certain period after treatment. This estimator is fundamental in analyzing time-to-event data, making it indispensable in clinical trials, epidemiological studies, and reliability engineering. By estimating survival probabilities, researchers can evaluate treatment effectiveness,...
536
01:25Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
192
In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
192