超越数字:CKD-EPI与MDRD在初级保健中的差异-慢性病阶段分类在117,055名患者中的差异
Nuno Capela1,2, Tiago Taveira-Gomes2,3, Cristina Gavina4
1Family Health Unit, Unidade de Saúde Familiar Serpa Pinto, ULS Santo António, 4250-384 Porto, Portugal.
Journal of clinical medicine
|March 14, 2026
概括
慢性病流行病学协作 (CKD-EPI) 方程将更多的患者分类为晚期慢性病 (CKD) 阶段,而不是在病中改变饮食 (MDRD) 方程. 这种差异在老年人和患有并发症的人群中尤为明显,这影响了初级保健中CKD的分期.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 初级医疗保健是一项主要的医疗保健.
- 流行病学 流行病学
背景情况:
- 慢性病 (CKD) 给全球健康带来了挑战,特别是在初级保健诊断和管理方面.
- 估计的淋巴膜过率 (eGFR) 对CKD分期至关重要,但不同的方程产生不同的分类.
- 本研究使用CKD-EPI和MDRD方程在初级保健环境中比较CKD分期.
研究的目的:
- 为了比较CKD阶段分类和分布使用CKD-EPI和MDRD方程在一个大型的初级保健队列.
- 探索这些基于方程的分类差异在常规初级医疗保健中的影响.
主要方法:
- 对117,055个葡萄牙初级医疗保健 (2000-2022) 电子健康记录的横截面分析.
- 基于KDIGO指导方针和最新的血清肌素的CKD分期 (G3-G5).
- 对CKD-EPI和MDRD方程的比较,跨年龄,BMI,白色素尿和并发症 (心力衰竭,糖尿病,高血压).
主要成果:
- CKD-EPI将更多的人分类为CKD G3-G5阶段 (7.73%) 比MDRD (6.57%).
- 在晚期 (G3b +29.4%,G4 +23.6%,G5 +34.4%) 与CKD-EPI之间,差异最为显著.
- CKD-EPI在老年人 (≥80岁) 和高危子组 (如心力衰竭患者) 中显示了较高的分类率.
结论:
- 与MDRD相比,CKD-EPI识别了较高比例的晚期CKD患者.
- 方程选择对CKD的分类有很大的影响,特别是在老年人和并发症患者中.
- 结果支持CKD-EPI对标准化的eGFR报告,同时指出差异反映了分类,而不是确诊.
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