简化肾脏病膳食改善方程在慢性肾脏病诊断及治疗中的应用  

Diagnostic value and application of modification of diet in renal disease in chronic renal disease

作　　者：赵兴波[1] 鄢盛恺[1] 李江[1] 

机构地区：[1]中日友好医院检验科,北京100029

出　　处：《检验医学》2010年第4期262-265,共4页Laboratory Medicine

摘　　要：目的通过检测患者肾小球滤过率(GFR)了解住院患者的肾功能及肾脏损害程度。应用简化肾脏病膳食改善(MDRD)方程估算GFR,为临床选择药物及用药量提供更可靠的依据。方法通过统计8 940例住院成年患者的基本信息,按照性别、年龄、疾病的不同类型及血肌酐水平进行分组。利用MDRD方程估算出患者的GFR。肾损害程度分期采用美国肾病学会(NKF)2002年的慢性肾脏病(CKD)分期。结果8 940例患者中,40.1%的患者存在肾功能不全(GFR<90 mL/min),32.1%的患者存在隐匿性肾功能不全(血肌酐<106μmol/L,GFR<90 mL/min)。506例体检者中有15.2%存在隐匿性肾功能不全。结论由于住院患者多数存在肾功能受损情况,院外部分人群存在隐匿性肾功能不全的隐患,因此应用MDRD方程能更准确地估算GFR值,有利于临床医生在治疗中采用不同的治疗方案。Objective To find out the renal function and the degree of renal injury by the detection of the glomerular filtration rate（GFR） of in-patients and use modification of diet in renal disease（MDRD） to provide a more reliable reference on drugs and dosage choosing.Methods 8 940 adult in-patients′ basic information were analyzed statistically and classified according to gender,age,different diseases and serum creatinine level.MDRD was used to estimate patients′ GFR.Renal injury was evaluated according to National Kidney Foundation（NKF） 2002 chronic kidney disease（CKD） staging method.Results There were 40.1% patients with renal insufficiency（GFR〈90 mL/min） and 32.1% patients with concealed renal insufficiency（serum creatinine〈106 μmol/L,GFR〈90 mL/min） in total 8 940 patients.In 506 healthy subjects,more than 15.2% ones presented concealed renal insufficiency.Conclusions Since many in-patients have renal injury,using MDRD to accurately estimate GFR can help clinical doctor to select better treatment.

关 键 词：肌酐 肾小球滤过率 简化肾脏病膳食改善方程 

分 类 号：R446.1[医药卫生—诊断学]