6种基于血肌酐的肾小球滤过率估算公式在健康人群中的应用评估被引量：17

Evaluation on the application of 6 creatinine-based equations of estimated glomerular filtration rate in healthy population

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摘要目的评价基于酶法和苦味酸速率法的血清肌酐的6种估算的肾小球滤过率（eGFR）公式在表观健康人群中的适用性。方法从健康体检人群中筛选出694名表观健康人，分别用酶学方法和碱性苦味酸速率法检测血清肌酐，通过6种eGFR公式[Cockcroft—Gault（C—G）公式、简化肾脏病膳食改善（MDRD）公式、MDRD-中国人公式、同位素稀释质谱法（IDMS）-MDRD公式、慢性肾脏病流行病合作组（CKD-EPI）公式和EPI-亚洲人（EPI-Asian）公式]分别计算其eGFR并进行比较。结果694名表观健康人群的血肌酐检测结果分别为酶法（65．8±13．3）μmolfL（范围为36～117μmol／L），苦味酸速率法（83．0±12．7）μmol／L（范围为57～131μmol／L）。以eGFR值男性85—125mL／min、女性75—115mL／min作为参考区间，基于酶法检测肌酐的eGFR值在表观健康人群中的适用性依次为CKD—EPI公式（72．3％）〉IDMS—MDRD公式（69．9％）〉简化MDRD公式（61．3％）〉EPI—Asian公式（60．7％）〉C—G公式（54．8％）〉MDRD一中国人公式（27．3％）（P〈0．05），IDMS—MDRD公式在男、女性之间的适用性差异最小（仅相差1．6％）；基于苦味酸速率法检测肌酐的eGFR值在表观健康人群中的适用性依次为MDRD一中国人公式（80．0％）〉EPI—Asian公式（70．1％）〉CKD—EPI公式（63．8％％）〉简化MDRD公式（59．1％）〉C—G公式（52．4％）〉IDMS—MDRD公式（40．7％）（P〈0．05），MDRD-中国人公式在男、女性之间的适用性差异最小（仅相差1％）。结论以上6种eGFR公式计算结果有明显差异。如果用溯源至IDMS的酶法检测血清肌酐，可选用CKD—EPI公式、IDMS—MDRD公式来评价中国北方健康人群的eGFR；如果用苦味酸速率法检测血清肌酐，可选用MDRD-中国人公式来评价中国北方健康人群的eGFR。 Objective To evaluate the application of 6 creatinine-based equations of estimated glomerular filtration rate （eGFR） by enzymatic method and kinetic alkaline picric acid rate method in healthy population. Methods Serum creatinine was measured by enzymatic method and kinetic alkaline picric acid rate method in 694 healthy subjects. The eGFR values were calculated and compared by 6 equations [ Cockcroft-Ganh （C-G） equation, simplified modification of diet in renal disease （MDRD） equation, MDRD-Chinese equation, isotopic dilution mass spectrometry （IDMS）-MDRD equation, chronic kidney disease epidemiology collaboration （CKD-EPI） equation and CKD-EPI for Asian （EPI-Asian） equation]. Results Serum creatinine results were（65.8 ＋ 13.3） ~mol/L[ （36-117） ~mol/L） for enzymatic method, （83.0 ＋ 12.7） ~mol/L[ （57-131）~mol/L~ for kinetic alkaline picric acid rate method. According to eGFR reference intervals： 85-125mL/min for males and 75-115mL/min for females, if using enzymatic method to detect creatinine, the applicability in healthy subjects of 6 equations were CKD-EPI equation （72.3%）〉 IDMS-MDRD equation（69.9% ）〉 simplified MDRD equation（61.3% ）〉 EPI-Asian equation （60.7%）〉 C-G equation（54.8% ）〉 MDRD-Chinese people equation （27.3%）（P 〈 0. 05）,and IDMS-MDRD equation showed the smallest difference between males and females （only 1.6% ）. If using kinetic alkaline picric acid rate method,the applicabilities in healthy subjects of 4 equations were MDRD-Chinese people equation（80. 0% ）〉 EPI-Asian equation （70. 1% ）〉 CKD-EPI equation （63.8%）〉 simplified MDRD equation（59.1% ）〉 C-G equation（52.4% ）〉 IDMS-MDRD equation（d0.7% ）（P 〈0.05） ,and MDRD-Chinese people equation showed the smallest difference between males and females （only 1% ）. Conclusions There are significant differences among 6 equations. To evaluate eGFR in healthy subjects in North China, CKD-EPI equation and IDMS-MDRD equation are more applicable if using enzymatic mehod traced to IDMS to detect serum creatnine ,while MDRD-Chinese people equation is more applicable if using kinetic alkaline picric acid rate method to detect serum creatnine.

作者贾珂珂杨硕乔蕊崔丽艳张捷

机构地区北京大学第三医院检验科

出处《检验医学》 CAS 2013年第12期1077-1082,共6页 Laboratory Medicine

关键词肾小球滤过率肌酐酶法苦味酸速率法健康人群 Glomerular filtration rate Creatinine Enzymatic method Kinetic alkaline picric acid rate method Healthy subject

分类号 R446.1 [医药卫生—诊断学]

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参考文献18

1Owen JE,Walker RG,Willems D, et al. Cadmiumtelluride detectors in the external measurement ofglomerular filtration rate using 99mTc-DTPA ( Sn):comparison with 51Cr-EDTA and 99mTc-DTPA ( Sn)plasma sample methods [ tf ]. Clin Nephrol, 1982,18(4):200-203.
2Li Zuo,Hai-Yan Wang. Selection of appropriate glo-merular filtration rate estimating equation [ J]. HongKong J Nephrol,2007,9 (1) : 15-22.
3Cockcroft DW,Gault MH. Prediction of creatinineclearance from serum creatinine[ J]. Nephron, 1976,16 (1) :3141.
4Levey AS, Bosch JP, Lewis JB, et al. A more accu-rate method to estimate glomerular filtration rate fromserum creatinine : a new prediction equation. Modifi-cation of diet in renal disease study group [ J]. AnnIntern Med, 1999,130 (6) :461-470.
5Ma YC,Zuo L,Chen JH, et al. Modified glomerularfiltration rate estimating equation for Chinese patientswith chronic kidney disease [ J ]. J Am Soc Nephrol,2006,17 (10) :2937-2944.
6Levey AS,Coresh J,Greene T,et al. Expressing themodification of diet in renal disease study equation forestimating glomerular filtration rate with standardizedserum creatinine values [ J ]. Clin Chem,2007,53(4):766-772.
7Levey AS, Stevens LA, Schmid CH, et al. A newequation to estimate glomerular filtration rate [ J ].Ann Intern Med,2009,150 (9) :604-612.
8Stevens LA, Claybon MA, Schmid CH,et al. Evalua-tion of the chronic kidney disease epidemiologycollaboration equation for estimating the glomerularfiltration rate in multiple ethnicities[ J]. Kidney Int,2011,79 (5) ; 555-562.
9府伟灵,徐克前.临床生物化学检验[M].第5版.北京:人民卫生出版社,2012.1:15.
10Grubb A,Nyman U,Bjork J,et al. Simple cystatin C-based prediction equations for glomerular filtrationrate compared with the modification of diet in renaldisease prediction equation for adults and the Schwarzand the Counahan-Barratt prediction equat ions forchildren[J] . Clin Chem,2005,51 (8) : 1420-1431.

二级参考文献26

1马迎春,左力,王梅,周玉红,张春丽,徐国宾,王海燕.肾小球滤过率评估方程在慢性肾脏病不同分期中的适用性[J].中华内科杂志,2005,44(4):285-289. 被引量：82
2史浩,陈楠,张文,任红,徐耀文,沈平雁,王伟铭,俞海瑾,李晓,冯晓蓓.简化MDRD公式预测慢性肾病患者肾小球滤过率的应用评价及校正[J].中国实用内科杂志,2006,26(5):665-669. 被引量：89
3全国eGFR课题协作组.MDRD方程在我国慢性肾脏病患者中的改良和评估[J].中华肾脏病杂志,2006,22(10):589-595. 被引量：729
4马宏星,王秀芹,杨月莉,陈雪民,张炜,王恒礼.肾小球滤过测算公式在慢性肾脏病中的应用评估[J].同济大学学报（医学版）,2007,28(1):52-55. 被引量：11
5Myers GL,Miller WG,Coresh J,et al. Recommendations for improving serum creatinine measurement:a report from the Laboratory Working Group of the National Kidney Disease Education Program [ J ]. Clin Chem, 2006,52( 1 ) :5-18.
6Levey AS, Greene T, Kusek J, et al. A simplified equation to predict glomerular filtration rate from serum creatinine [ J ]. J Am Soc Nephrol,2000,11 :A0828.
7Coresh J, Byrd-Holt D, Astor BC, et al. Chronic kidney disease awareness,prevalence, and trends among U. S. adults, 1999 to 2000 [ J ]. J Am Soc Nephrol,2005,16 (1) :180-188.
8Levey AS, Bosch JP, Lewis JB, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine : a new prediction equation. Modification of diet in renal disease study group[ J ]. Ann Intern Med, 1999,130 (6) :461-470.
9Levey AS, Coresh J, Balk E,et al. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification [J]. Ann Intern Med,2003,139(2):137-147.
10National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification [ J ]. Am J Kidney Dis,2002,39(2 Suppl 1 ):S1-S266.