CKD-EPI 2021 eGFR公式在健康体检人群中的应用  

Application of CKD-EPI 2021 eGFR formula in the healthy physical examination population

作　　者：关若萍 罗利利 戴国奎 李丹娜 姜顾礼 GUAN Ruoping;LUO Lili;DAI Guokui;LI Danna;JIANG Guli(Department of Clinical Laboratory,Guangzhou Cadre Health Management Center,Guangzhou,Guangdong 510530,China)

机构地区：[1]广州市干部健康管理中心检验科,广东广州510530

出　　处：《检验医学与临床》2023年第17期2569-2574,共6页Laboratory Medicine and Clinic

摘　　要：目的应用慢性肾脏病流行病学协作(CKD-EPI)2021估算肾小球过滤率(eGFR)公式分析健康体检人群肾功能下降情况及相关影响因素,为科学防治CKD提供决策依据。方法选取2020年1-12月在广州市干部健康管理中心健康体检的51206名广州地区健康体检人群作为研究对象,并收集体检资料。采用回顾性研究,分析CKD-EPI 2021公式、CKD-EPI 2009公式及湘雅方程计算eGFR的差异,并分析健康体检人群eGFR下降情况及其与性别、年龄、体质量指数(BMI)、幽门螺杆菌、血压、血糖、血脂、尿素、血尿酸(UA)等因素的关系。采用多因素Logistic回归分析eGFR下降的影响因素。结果与CKD-EPI 2009公式比较,CKD-EPI 2021公式提高了30~120 mL/(min·1.73 m^(2))人群的eGFR。在51206名受试者肾功能下降的总体检出率为14.70%(7529/51206)。对eGFR<60 mL/(min·1.73 m^(2))人群检出比例,CKD-EPI 2021公式较CKD-EPI 2009公式更接近湘雅方程。CKD-EPI 2021公式中基于肌酐(Cr)公式与基于Cr-胱抑素C(Cys)公式计算的eGFR存在差异。多因素Logistic回归分析结果显示,男性、年龄增长、高UA是影响eGFR下降的独立危险因素(P<0.05);空腹血糖升高是影响eGFR下降的保护因素(P<0.05);BMI、血压、糖化血红蛋白、甘油三酯、总胆固醇、尿蛋白、尿红细胞不是eGFR下降的影响因素(P>0.05)。结论CKD-EPI 2021 eGFR公式可用于健康体检人群肾功能评估,建议使用联合Cr和CysC的公式。老年人肾小球滤过率下降较快,应关注相关因素对CKD进展的长期危害,积极进行生活方式干预和原发病的治疗。Objective To analyze the decline of renal function and related influencing factors in health physical examination population using the chronic kidney disease epidemiological collaboration(CKD-EPI)2021 estimated glomerular filtration rate(eGFR)formula,and to provide decision-making basis for scientific prevention and treatment of CKD.Methods A total of 51206 healthy people in Guangzhou who underwent physical examination in Guangzhou Cadre Health Management Center from January to December 2020 were selected as the research objects,and the physical examination data were collected.A retrospective study was conducted to analyze the differences of eGFR calculated by CKD-EPI 2021 formula,CKD-EPI 2009 formula and Xiangya formula.The relationship between eGFR decline and gender,age,body mass index(BMI),Helicobacter pylori,blood pressure,blood glucose,blood lipid,urea nitrogen,serum uric acid(UA)and other factors were analyzed.Multivariate Logistic regression was used to analyze the influencing factors of eGFR decline.Results Compared with the CKD-EPI 2009 formula,the CKD-EPI 2021 formula increased the eGFR in the population of 30-120 mL/(min·1.73 m^(2)).The overall detection rate of renal dysfunction in 51206 subjects was 14.70%(7529/51206).The CKD-EPI 2021 formula was closer to the Xiangya formula than the CKD-EPI 2009 formula in the detection rate of eGFR<60 mL/(min·1.73 m^(2)).In CKD-EPI 2021 formula,there were differences in eGFR calculated by creatinine(Cr)formula and Cr-cystain C(Cys)formula.Multivariate logistic regression analysis showed that male,age,and high UA were risk factors for eGFR decline(P<0.05),and increased fasting blood glucose was a protective factor for eGFR decline(P<0.05).BMI,blood pressure,glycosylated hemoglobin,triglyceride,total cholesterol,urine protein and urine red blood cell were not the influencing factors of eGFR decline(P>0.05).Conclusion The CKD-EPI 2021 eGFR formula can be applied to the assessment of renal function in a healthy physical examination population,and the formula combin

关 键 词：估算肾小球滤过率 公式 健康体检 

分 类 号：R446.1[医药卫生—诊断学]