不同肾小球滤过率估测公式评估北京社区老年人群肾功能和慢性肾脏疾病患病率的差异  

Comparisons of four equations to estimate giomerular filtration rate and their impacts on chronic kidney disease prevalence in community-dwelling elderly people in Beijing

作　　者：张雪晗[1] 谢海雁[1] 姜鸿[1] 秦明伟[1] 李冬晶[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院保健医疗部,100730

出　　处：《中华老年医学杂志》2016年第2期179-184,共6页Chinese Journal of Geriatrics

摘　　要：目的了解应用不同的肾小球滤过率估测（eGFR）公式，在北京社区老年人群中评估肾脏功能和慢性肾脏疾病（CKD）患病率的差异。方法选取年龄≥70岁老年人489例，分别应用Cockcroft-Gauh（CG）公式、慢性肾脏病流行病学合作研究公式（chronickidneydisease—epidemiologycollaboration，CKD-EPI）、肾脏病膳食改良试验公式（modification of diet in renal disease，MDRD）、柏林倡议研究（Berlin Initiative Study，BIS）公式计算GFR（计量单位：ml·min-1·1．73m-2），并进行一致性检验。结果人选者平均年龄（81．8±7．6）岁，采用CG、CKD-EPI、MDRD和BIS公式计算的eGFR平均值分别为58．4±17．2、71．9±15．3、76．7±19．1和62．7±12．7；CKD患病率分别为56．2％、22．7％、17．8％和41．7％。在年龄≥90岁、体质指数〈20．0kg／m。和血肌酐水平〈88．4umol／L的人群中，不同公式计算的eGFR差异较大。结论在老年人群中采用不同eGFR公式计算得到的GFR差异较大，并会影响CKD分期结果，应慎重对待应用eGFR公式计算的GFR及CKD分期结果。临床工作中亟待确定适合老年人群的eGFR公式。Objective To investigate the differences of four equations to estimate glomerular filtration rate （GFR） and their impacts on chronic kidney disease （CKD） prevalence in community- dwelling elderly people in Beijing. Methods A total of 489 participants aged above 70 years were enrolled. The GFR was estimated using the Cockcroft-Gault （CG） equation, Chronic Kidney Disease- Epidemiology Collaboration （CKD-EPI） equation, Modification of Diet in Renal Disease （MDRD） equation and Berlin Initiative Study （BIS） equation respectively. The internal-consistency check was made on the four equations for the GFR （ml min-1 1.73m-2） estimates. Results The mean age of participants was （81.8±7.6） years. The mean GFR estimated using the CG, CKD-EPI, MDRD and BIS equation was 58.4±17.2, 71.9±15.3, 76.7±19.1 and 62.7±12.7, respectively. And the prevalence of CKD was 56.2%, 22.7%, 17.8% and 41.7%, respectively. The greatest differences of equations to estimate GFR were seen in elderly people aged 90 and above, and those with body mass index〈 20.0 kg/m2 or serum creatinine concentration〈 88.4 umol/L. Conclusions The GFR estimated using different equations has a large difference which has a significant effect on CKD classification in elderly people. The equation to estimate GFR for the elderly is urgently needed. Until then, the eGFR and CKD classification estimated using different equations should be regarded with caution.

关 键 词：肾小球滤过率 肾功能衰竭 慢性 

分 类 号：R692[医药卫生—泌尿科学]