机构地区:[1]Department of Nephrology, Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing 100853, China [2]Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology of Zhengzhou University, Key laboratory of precision diagnosis and treatment for chronic kidney disease in Henan province, Zhengzhou. Henan 450052, China [3]Central Laboratory, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya, Hainan 572000, China [4]Department of Management, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya, Hainan 572000, China
出 处:《Chinese Medical Journal》2019年第5期512-518,共7页中华医学杂志(英文版)
基 金:National Key R&D Program of China (No.2016YFC1305500);Key Research and Development Program of Hainan (Nos.ZDYF2016135 and ZDYF2017095);the National Natural Science Foundation of China (Nos.61471399,61671479,and 81670663);the National Key Research and Development Program (No. 2016YFC1305404);the Joint Funds of National Natural Science Foundation of China and Henan province (No.U1604284).
摘 要:Background: Accurate estimation of the glomerular filtration rate (GFR) and staging of chronic kidney disease (CKD) are important. Currently, there is no research on the differences in several estimated GFR equations for staging CKD in a large sample of centenarians. Thus, this study aimed to investigate the differences in CKD staging with the most commonly used equations and to analyze sources of discrepancy. Methods: A total of 966 centenarians were enrolled in this study from June 2014 to December 2016 in Hainan province, China. The GFR with the Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Berlin Initiative Study 1 (BIS1) equations were estimated. Agreement between these equations was investigated with the k statistic and Bland-Altman plots. Sources of discrepancy were investigated by partial correlation analysis. Results: The k values of the MDRD and CKD-EPI equations, MDRD and BIS1 equations, and CKD-EPI and BIS1 equations were 0.610, 0.253, and 0.381, respectively. Serum creatinine (Scr) explained 10.96%, 41.60% and 17.06% of the variability in these three comparisons, respectively. Serum uric acid (SUA) explained 3.65% and 5.43% of the variability in the first 2 comparisons, respectively. Gender was associated with significant differences in these 3 comparisons (P<0.001). Conclusions: The strengths of agreement between the MDRD and CKD-EPI equations were substantial, but those between the MDRD and BIS 1 equations and the CKD-EPI and BIS 1 equations were fair. The difference in CKD staging of the first 2 comparisons strongly depended on Scr, SUA and gender, and that of CKD-EPI and BIS1 equations strongly depended on Scr and gender. The incidence at various stages of CKD staging was quite different. Thus, a new equation that is more suitable for the elderly needs to be built in the future.
关 键 词:CHINESE CENTENARIANS Estimated glomerular filtration rate Modification of Diet in RENAL DISEASE EQUATION Chronic Kidney DISEASE Epidemiology Collaboration EQUATION Berlin Initiative Study 1 EQUATION
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