中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
Chinese Journal of Nephrology
2015年
10期
755-759
,共5页
肾小球滤过率%外周血管疾病%MDRD评估公式%CKD-EPI评估公式
腎小毬濾過率%外週血管疾病%MDRD評估公式%CKD-EPI評估公式
신소구려과솔%외주혈관질병%MDRD평고공식%CKD-EPI평고공식
Glomerular filtration rate%Peripheral vascular diseases%MDRD equation%CKD-EPI equation
目的 比较简化MDRD公式与慢性肾脏病学流行病学合作研究(CKD-EPI)公式在评估外周动脉疾病(peripheral arterial disease,PAD)患者肾小球滤过率(GFR)中的适用性.方法 采用回顾性队列研究,选择2005年在上海市和北京市8家医院被确诊为PAD的841例患者作为研究对象,分别利用MDRD与CKD-EPI公式估算肾小球滤过率(eGFR),应用Spearman相关性检验、Bland-Ahman曲线和Kappa检验比较两种方程估算GFR的相关性和一致性,并利用净重新分类指数(net re-classification improvement,NRI)比较2个公式对死亡风险的评估能力.结果 eGFRMDRD高于eGFRcKD-EPI,均值差为4.33 ml· min-1·(1.73 m2)-1,但两者评估eGFR值的相关性和一致性良好(Kappa值为0.749,r=0.991,P＜0.05).以MDRD为标准,CKD-EPI公式改变了152例(18.1％)患者的分期,其中9例(1.1％)分期上调,143例(17.0％)分期下调.全因死亡NRI为0.059 (P＜ 0.05),心血管死亡NRI为0.022(P＞0.05),提示CKD-EPI公式仅对全因死亡的风险评估能力优于MDRD.结论 CKD-EPI公式在PAD患者中的应用并未显著优于MDRD公式.
目的 比較簡化MDRD公式與慢性腎髒病學流行病學閤作研究(CKD-EPI)公式在評估外週動脈疾病(peripheral arterial disease,PAD)患者腎小毬濾過率(GFR)中的適用性.方法 採用迴顧性隊列研究,選擇2005年在上海市和北京市8傢醫院被確診為PAD的841例患者作為研究對象,分彆利用MDRD與CKD-EPI公式估算腎小毬濾過率(eGFR),應用Spearman相關性檢驗、Bland-Ahman麯線和Kappa檢驗比較兩種方程估算GFR的相關性和一緻性,併利用淨重新分類指數(net re-classification improvement,NRI)比較2箇公式對死亡風險的評估能力.結果 eGFRMDRD高于eGFRcKD-EPI,均值差為4.33 ml· min-1·(1.73 m2)-1,但兩者評估eGFR值的相關性和一緻性良好(Kappa值為0.749,r=0.991,P＜0.05).以MDRD為標準,CKD-EPI公式改變瞭152例(18.1％)患者的分期,其中9例(1.1％)分期上調,143例(17.0％)分期下調.全因死亡NRI為0.059 (P＜ 0.05),心血管死亡NRI為0.022(P＞0.05),提示CKD-EPI公式僅對全因死亡的風險評估能力優于MDRD.結論 CKD-EPI公式在PAD患者中的應用併未顯著優于MDRD公式.
목적 비교간화MDRD공식여만성신장병학류행병학합작연구(CKD-EPI)공식재평고외주동맥질병(peripheral arterial disease,PAD)환자신소구려과솔(GFR)중적괄용성.방법 채용회고성대렬연구,선택2005년재상해시화북경시8가의원피학진위PAD적841례환자작위연구대상,분별이용MDRD여CKD-EPI공식고산신소구려과솔(eGFR),응용Spearman상관성검험、Bland-Ahman곡선화Kappa검험비교량충방정고산GFR적상관성화일치성,병이용정중신분류지수(net re-classification improvement,NRI)비교2개공식대사망풍험적평고능력.결과 eGFRMDRD고우eGFRcKD-EPI,균치차위4.33 ml· min-1·(1.73 m2)-1,단량자평고eGFR치적상관성화일치성량호(Kappa치위0.749,r=0.991,P＜0.05).이MDRD위표준,CKD-EPI공식개변료152례(18.1％)환자적분기,기중9례(1.1％)분기상조,143례(17.0％)분기하조.전인사망NRI위0.059 (P＜ 0.05),심혈관사망NRI위0.022(P＞0.05),제시CKD-EPI공식부대전인사망적풍험평고능력우우MDRD.결론 CKD-EPI공식재PAD환자중적응용병미현저우우MDRD공식.
Objective To compare the performance of newly developed Chronic Kidney Disease Epideniology Collaboration (CKD-EPI) equation and Modification of Diet in Renal Disease (MDRD) equation in patients with peripheral arterial diseases (PAD).Methods A total of 841 patients with PAD were enrolled in this retrospective cohort study.Estimated glomerular filtration rate (eGFR), calculated by MDRD and CKD-EPI equation respectively, was analyzed by Spearman correlation analysis, Bland-Altman method and Kappa test for the evaluation of correlation and consistency.Net reclassification improvement (NRI) was adopted to compare the death risk assessment between these two equations.Results Although the eGFR was 4.33 ml· min-1 · (1.73 m2)-1 higher with MDRD equation than with CKD-EPI equation, there were still significant correlation and fine consistency between eGFRMDRD and eGFRCKD-EPI (Kappa: 0.749, r=0.991, P＜0.05).The CKD-EPI equation re-classified 9 (1.1％) patients upward to higher eGFR category and 143 (17.0％) patients downward to lower eGFR category.Besides, the performance of risk assessment for all-cause death was better with CKD-EPI equation than with MDRD equation (NRI=0.059, P ＜ 0.05), which was not the case for cardiovascular death (NRI=0.022, P ＞ 0.05).Conclusions There is no solid evidence suggesting that CKD-EPI equation performs better than MDRD equation.
