PDF(Pubmed)
Abstract：
BACKGROUND: At present, estimated glomerular filtration rate (eGFR) remains the most frequently utilized parameter in the evaluation of kidney injury severity. Numerous equations have been formulated based on serum creatinine (Scr) or serum cystatin C (Cysc) levels. However, there is a lack of consensus regarding the efficacy of these equations in assessing eGFR, particularly for elderly individuals in China. This study aimed to evaluate the applicability of the MDRD, MDRDc, CKD-EPI series, BIS1, and FAS equations within the Chinese elderly population.
METHODS: A cohort of 298 elderly patients with measured GFR (mGFR) was enrolled. The patients were categorized into three subgroups based on their mGFR levels. The eGFR performance was examined, taking into account bias, interquartile range (IQR), accuracy P30, and root-mean-square error (RMSE). Bland-Altman plots were employed to verify the validity of eGFR.
RESULTS: The participants had a median age of 71 years, with 167 (56.0%) being male. Overall, no significant differences in bias were observed among the seven equations (P > 0.05). In terms of IQR, P30, and RMSE, the BIS1 equation demonstrated superior accuracy (14.61, 72.1%, and 13.53, respectively). When mGFR < 30 ml/min/1.73 m2, all equations underestimated the true GFR, with the highest accuracy reaching only 59%. Bland-Altman plots indicated that the BIS1 equation exhibited the highest accuracy, featuring a 95% confidence interval (CI) width of 52.37.
CONCLUSIONS: This study suggested that the BIS1 equation stands out as the most applicable for estimating GFR in Chinese elderly patients with normal renal function or only moderate decline. 2020NL-085-03, 2020.08.10, retrospectively registered.
METHODS: A cohort of 298 elderly patients with measured GFR (mGFR) was enrolled. The patients were categorized into three subgroups based on their mGFR levels. The eGFR performance was examined, taking into account bias, interquartile range (IQR), accuracy P30, and root-mean-square error (RMSE). Bland-Altman plots were employed to verify the validity of eGFR.
RESULTS: The participants had a median age of 71 years, with 167 (56.0%) being male. Overall, no significant differences in bias were observed among the seven equations (P > 0.05). In terms of IQR, P30, and RMSE, the BIS1 equation demonstrated superior accuracy (14.61, 72.1%, and 13.53, respectively). When mGFR < 30 ml/min/1.73 m2, all equations underestimated the true GFR, with the highest accuracy reaching only 59%. Bland-Altman plots indicated that the BIS1 equation exhibited the highest accuracy, featuring a 95% confidence interval (CI) width of 52.37.
CONCLUSIONS: This study suggested that the BIS1 equation stands out as the most applicable for estimating GFR in Chinese elderly patients with normal renal function or only moderate decline. 2020NL-085-03, 2020.08.10, retrospectively registered.
摘要：
背景：目前，估计的肾小球滤过率(eGFR)仍然是评估肾损伤严重程度最常用的参数.已经基于血清肌酸酐(Scr)或血清胱抑素C(Cysc)水平制定了许多方程。然而,关于这些方程在评估eGFR时的有效性缺乏共识，特别是中国的老年人。本研究旨在评估MDRD的适用性，MDRDc,CKD-EPI系列,中国老年人群中的BIS1和FAS方程。
方法：纳入298例测量GFR（mGFR）的老年患者队列。根据mGFR水平将患者分为三个亚组。检查了eGFR性能，考虑到偏见，四分位数间距(IQR)，精度P30和均方根误差(RMSE)。Bland-Altman地块用于验证eGFR的有效性。
结果：参与者的平均年龄为71岁，男性有167人（56.0％）。总的来说,7个方程间的偏倚差异无统计学意义(P>0.05)。就IQR而言，P30和RMSE,BIS1方程显示出较高的精度(14.61，72.1%，和13.53）。当mGFR<30ml/min/1.73m2时，所有方程都低估了真实的GFR，最高精度仅为59％。Bland-Altman图表明BIS1方程表现出最高的精度，具有95%置信区间(CI)宽度为52.37。
结论：这项研究表明，BIS1方程最适用于估计肾功能正常或仅中度下降的中国老年患者的GFR。2020NL-085-03，2020.08.10，回顾性注册。
方法：纳入298例测量GFR（mGFR）的老年患者队列。根据mGFR水平将患者分为三个亚组。检查了eGFR性能，考虑到偏见，四分位数间距(IQR)，精度P30和均方根误差(RMSE)。Bland-Altman地块用于验证eGFR的有效性。
结果：参与者的平均年龄为71岁，男性有167人（56.0％）。总的来说,7个方程间的偏倚差异无统计学意义(P>0.05)。就IQR而言，P30和RMSE,BIS1方程显示出较高的精度(14.61，72.1%，和13.53）。当mGFR<30ml/min/1.73m2时，所有方程都低估了真实的GFR，最高精度仅为59％。Bland-Altman图表明BIS1方程表现出最高的精度，具有95%置信区间(CI)宽度为52.37。
结论：这项研究表明，BIS1方程最适用于估计肾功能正常或仅中度下降的中国老年患者的GFR。2020NL-085-03，2020.08.10，回顾性注册。
