CKD-EPI公式在我国老年慢性肾脏病患者中的适应性研究

摘要

Objective To evaluate the applicability of Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation to estimate glomerular filtration rate in Chinese elderly patients (≥ 65) with chronic kidney disease.Method 146 elderly patients (≥ 65) with CKD were evaluated for the correlation between eGFR and sGFR.Results Correlation analysis revealed eGFR was positively correlated with sGFR (r =0.776,P ＜ 0.01).The significant correlation between eGFR and sGFR existed both when sGFR ＜ 60 ml/(min · 1.73 m2) and when sGFR ＞ 60 ml/(min · 1.73 m2).Average deviation of eGFR from sGFR was (-1.79 ± 13.42) ml/(min · 1.73 m2).There was no significantly statistical deviation both in general and the point with 60 ml/(min · 1.73 m2) as the diagnostic cut-off point.15％,30％ and 50％ coincidence rates of eGFR were 43.15％,69.86％ and 86.99％ respectively.The coincidence rate of eGFR in sGFR ＞ 60 ml/(min · 1.73 m2) was higher than that in sGFR ＜ 60 ml/(min · 1.73 m2).Conclusions CKD-EPI equation has a less deviation and a higher accuracy for evaluation of GFR in elderly patients (≥ 65) with CKD.When estimating GFR at higher values,it may be underestimated by CKD-EPI equation.So,more prospective and multiple medical center should include large subjects to further assess the usefulness of CKF-EPI equation in estimating GFR in Chinese elderly patients (≥ 65) with CKD.%目的 探讨慢性肾脏病流行病学合作研究(CKD-EPI)公式在中国65岁以上老年慢性肾脏病(CKD)患者中评估肾小球滤过率(GFR)的适用性及其应用价值,为临床评估CKD患者GFR提供一定的依据.方法 选择我院老年肾脏病科CKD患者146例作为研究对象.首先采用CKD-EPI公式计算eGFR,然后予标准化GFR进行相关性分析.结果 相关性分析提示eGFR与sGFR呈正相关(r =0.776,P＜ 0.01).不论在总体的适用性,还是以60ml·min-1· (1.73m2)-1为分界点时:CKD-EPI公式得出的eGFR与sGFR均显示明显的相关性.eGFR与sGFR的平均偏差为(-1.79±13.42)ml·min-1·(1.73 m2)-1(配对t检验,t=1.249,P=0.214),当sGFR＞60 ml·min-1·(1.73 m2)-1时偏差较大,偏差值为(-3.03±11.11)ml·min-1·(1.73m2)-1,当sGFR＜60 ml·min-1·(1.73 m2)-1时,偏差较小,偏差值为(-0.70±14.27) ml·min-1·(1.73 m2)-1,但偏差均无统计学意义(P＞0.05).eGFR的15％、30％及50％符合率分别为43.15％、69.86％和86.99％.其中sGFR＞60 ml·min-1·(1.73 m2)-1时符合率较好,分别为60.47％、93.02％及100％,而sGFR＜60 ml·min-1·(1.73m2)-1时符合率稍差,分别是34.95％、60.19％及81.55％.结论 CKD-EPI公式在应用于我国65岁以上老年CKD患者评估GFR时,准确性较高,CKD-EPI公式在评估较高的GFR时,与sGFR偏差较小,说明在老年CKD患者中CKD-EPI公式有低估GFR的倾向,其评估中国65岁以上老年CKD患者GFR的适用性尚需进一步扩大样本量,以协作组的方式进行大规模研究.