| 摘要: |
| 目的:评价校正后简化MDRD方程预测慢性肾脏病（CKD）患者肾小球滤过率（GFR）的适用性。方法:选择2005年1月至2007年1月在我院肾内科就诊的CKD患者481例，所有患者同步检验99mTc-GFR(reference GFR,rGFR)、血浆肌酐（Pcr），并用简化MDRD方程（aGFR=186×\[Pcr\]-1.154×\[年龄(岁)\]-0.203×\[女性×0.742\]）、校正后简化MDRD方程（c-aGFR=175×\[Pcr\]-1.234×\[年龄(岁)\]-0.179×\[女性×0.79\]）计算预测的GFR，二者进行预测偏离度、精确度、准确性比较。结果:（1）总体比较：简化MDRD方程、校正后简化MDRD方程预测的估测GFR(estimated GFR,eGFR)与rGFR均呈显著相关(P<0.01)。与简化MDRD方程比较，校正后简化MDRD方程预测的eGFR表现了较低的偏差和绝对偏差(P<0.01)；除预测的精确度略有增加，校正后简化MDRD较简化MDRD方程15%、30%和50%的准确性、预测的偏离度均有改善(P<0.05)。（2）CKD各期比较：与简化MDRD方程比较，校正后简化MDRD方程减小了除CKD 5期外其余各期的偏差(P<0.05)，减小了CKD 1期的绝对偏差(P<0.05)；提高了CKD 2期30%的准确性(P<0.01)。结论:校正后简化MDRD方程与简化MDRD方程比较，无论从总体或是CKD各期来讲，均显示出不同程度的优势。在目前暂无更好GFR评估方程的背景下，可用于我国CKD患者GFR的评估。 |
| 关键词: 慢性肾疾病 肾小球滤过率 简化MDRD方程 |
| DOI：10.3724/SP.J.1008.2009.0404 |
| 投稿时间：2008-07-29修订日期：2009-02-24 |
| 基金项目: |
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| Modified MDRD equation in predicting glomerular filtration rate in patients with chronic kidney disease: an assessment of applicability |
| LI Jiang-tao1,MA Hong-xing2,MA Jun1* |
| (1.Department of Nephrology, Tongji Hospital, Tongji University, Shanghai 200065,China;2.Department of Nuclear Medicine, Tongji Hospital, Tongji University, Shanghai 200065) |
| Abstract: |
| Objective:To evaluate the applicability of modified MDRD equation in predicting Glomerular filtration rate in patients with chronic kidney disease (CKD). Methods: Totally 481 CKD patients, who were diagnosed based on K/DOQI guideline from Jan. 2005 to Jan. 2007 in our hospital, were enrolled in this study. The sex, age, body weight and height of patients were recorded; the plasma creatinine，serum albumin and 99mTc-GFR( standardized by body surface area) were measured. GFRs were estimated by abbreviated MDRD equation and the modified MDRD equation separately. The bias, accuracy and precision of both equations were compared. Results: The estimated GFRs (eGFRs) by both equations were significantly correlated with the rGFR(P<0.01).Except for the slightly decreased precision, the modified MDRD equation showed great improvements in the 5%, 30%, and 50% accuracy and bias when compared with the original abbreviated MDRD equation(P<0.05). Compared with the original equation，the modified MDRD equation showed smaller bias in all stages of CKD except for stage 5(P<0.05). The modified MDRD equation also decreased the absolute bias and improved the 30% accuracy in stage 2 CKD (P<0.01).Conclusion: Compared with original equation, the modified MDRD equation has great advantages in predicting the total GFR and GFRs at different CKD stages. Currently it can be used in predicting the GFR of Chinese CKD patients. |
| Key words: Chronic kidney disease Glomerular filtration rate abbreviated MDRD equation |
