一项系统性审查,评估南亚人群中估计的GFR性能
Rouvick Mariano Gama1, Ayush Sinha2, Alexander Sarnowski3
1Department of Inflammation Biology, Faculty of Life Sciences and Medicine, School of Immunology and Microbial Science, King's College London, London, UK.
Kidney international reports
|January 19, 2026
概括
估计的淋巴膜过率 (eGFR) 方程显示南亚人的表现变化. 组合方程 (eGFRCr-CysC) 提供了最好的准确性,尽管所有测试的方程都低于临床值.
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) 方程对于评估功能至关重要.
- 现有的eGFR方程在不同人群中显示出可变的准确性,特别是在南亚人群中.
研究的目的:
- 系统地审查和元分析基于肌素 (eGFRCr),基于囊素 (eGFRCysC) 和结合 (eGFRCr-CysC) 的方程与南亚人测量的GFR (mGFR) 的表现.
- 确定影响这些eGFR方程偏差和准确性的因素.
主要方法:
- 在主要数据库 (PubMed,Embase,Scopus,Web of Science,Cochrane) 中对1976年至2024年间发表的研究进行了系统的文献搜索.
- 进行了元分析,以评估EGFR方程的偏差 (标准化平均差异) 和30%的准确性 (P30) 与mGFR相比.
- 多变量元回归被用来探索调节者的影响,如年龄,性别,种族和队列类型.
主要成果:
- 在分析中包括了35个队列 (n=4725).
- eGFRCr方程通常高估了mGFR,CKD-EPI-2009Cr显示了最高的偏差 (SMD=0.66).
- 对于eGFRCysC等式,偏差最小 (-0.03到0.15),但对eGFRCr和eGFRCysC的准确性 (P30) 都低于75%. 结合的eGFRCr-CysC方程获得了最好的P30 (79-82%).
结论:
- 目前的eGFR方程式在南亚人群中显示出低于最佳的准确性,始终未能达到75%的P30临床基准.
- 虽然eGFRCysC方程减少了偏差,但结合eGFRCr-CysC方程提供了更高的准确性.
- 建议对新出现的方程,如CKD-EPI-Pakistan和EKFC进行进一步的研究,重点是对不同南亚群体的人口特异性校准.
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