estimated kidney function

  • 文章类型: Journal Article
    未经评估:最近的研究评估并提出了新的种族中立,基于肌酐的肾小球滤过率(GFR)估计方程。这些方程式在各种潜在的活体肾脏供体中的表现需要研究。
    未经评估:横断面研究。
    UNASSIGNED:在2016年10月至2020年12月期间,来自一家三级医院的637名潜在活体肾脏捐献者通过碘海醇血浆清除率测量血清肌酐浓度和GFR。
    UNASSIGNED:通过慢性肾脏病流行病学合作(2009年,CKDEPI09;2021年,CKDEPI21)对肾脏疾病方程中饮食的修改,包括和不包括种族系数,如适用。
    未经评估:方程偏差,精度,准确度,以及GFR的准确分类等于和高于或低于80mL/min/1.73m2。
    UNASSIGNED:GFR估算方程性能与通过碘海醇清除率测得的GFR(mGFR)相比。
    UNASSIGNED:CKDEPI21方程的中值偏差将mGFR低估了2.8mL/min/1.73m2。Black亚组的偏差将mGFR低估了9.0mL/min/1.73m2。与有和没有种族调整的CKDEPI09相比,CKDEPI21的准确性在所有亚组中都增加。平均而言,3.9%的人被CKDEPI21错误分类为GFR大于,和8.9%的错误分类少于,80mL/min/1.73m2,相比之下,有种族调整的CKDEPI09为3.1%和13.2%,分别。CKDEPI21的总分类错误(高于或低于80mL/min/1.73m2)为16.3%,CKDEPI09为16.0%(种族调整)。
    未经授权:识别为黑人的个人样本有限。缺乏胱抑素C数据。
    未经证实:在我们潜在的活体供体样本中,通过基于肌酐的CKDEPI21估计的GFR比先前基于肌酐的估计的GFR方程更少偏差且更准确。当按种族评估时,这种总结性的改进仍然存在于被认定为亚洲人的个人中,西班牙裔,或白色。需要更多的外部验证来评估新方程是否比以前的具有竞争系数的CKDEPI方程有所改进。
    UNASSIGNED: Recent studies evaluated and proposed new race-neutral, creatinine-based glomerular filtration rate (GFR) estimation equations. The performance of these equations in diverse potential living kidney donors requires study.
    UNASSIGNED: Cross-sectional study.
    UNASSIGNED: 637 potential living kidney donors from one tertiary hospital with serum creatinine concentration measurement and GFR measurement by iohexol plasma clearance between October 2016 and December 2020.
    UNASSIGNED: Creatinine-based estimation of GFR by Chronic Kidney Disease Epidemiology Collaboration (2009, CKDEPI09; 2021, CKDEPI21) and Modification of Diet in Renal Disease equations with and without inclusion of race coefficient, where applicable.
    UNASSIGNED: Equation bias, precision, accuracy, and accurate classification of GFR as equal to and above or below 80 mL/min/1.73 m2.
    UNASSIGNED: GFR estimation equation performance compared to measured GFR (mGFR) by iohexol clearance.
    UNASSIGNED: The median bias of the CKDEPI21 equation underestimated mGFR by 2.8 mL/min/1.73 m2. The bias in the Black subgroup underestimated mGFR by 9.0 mL/min/1.73 m2. Compared to CKDEPI09 with and without race adjustment, the accuracy of CKDEPI21 increased across all subgroups. On average, 3.9% of individuals were misclassified by CKDEPI21 as having a GFR greater than, and 8.9% misclassified less than, 80 mL/min/1.73 m2, compared to 3.1% and 13.2% for CKDEPI09 with race adjustment, respectively. Total misclassification (either above or below 80 mL/min/1.73 m2) was 16.3% for CKDEPI21 and 16.0% for CKDEPI09 (with race adjustment).
    UNASSIGNED: Limited sample of individuals identifying as Black. Lack of cystatin C data.
    UNASSIGNED: In our potential living donor sample, GFR estimation by creatinine-based CKDEPI21 is less biased and more accurate than previous creatinine-based estimated GFR equations. When evaluated by race, this summative improvement remains in individuals identifying as Asian, Hispanic, or White. More external validation is needed to assess whether the new equation is an improvement over the previous CKDEPI equation with a race coefficient.
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  • 文章类型: Journal Article
    尚未建立卧床的老年患者万古霉素(VCM)的给药计划。这项回顾性研究旨在通过贝叶斯方法使用基于肌酐的估计的此类患者的肾功能方程来评估VCM的浓度-时间曲线(AUC)下面积的预测准确性。使用日本估算的肾小球滤过率(eGFR)方程和估算的肌酐清除率(eCCr)的Cockcroft-Gault方程估算肾功能。通过将SCr水平+0.2mg/dL代入Cockcroft-Gault方程来计算eCCr(血清肌酐(SCr)+0.2)。对于eGFR/0.789,eGFR,eCCr,和eCCr(SCr+0.2),AUC值通过贝叶斯方法使用治疗药物监测(TDM)软件计算,BMs-Pod(版本8.06),表示为AUCeGFR/0.789,AUCeGFR,AUCeCCr,和AUCeCCr(SCr+0.2)。通过将VCM的峰和谷稳态浓度应用于一级药代动力学方程来计算参考AUC(AUCREF)。AUCeGFR/0.789/AUCREF的中位数(范围),AUCeGFR/AUCREF,AUCeCCr/AUCREF,AUCeCCr(SCr+0.2)/AUCREF为0.88(0.74-0.93),0.90(0.79-1.04),0.92(0.81-1.07),和1.00(0.88-1.11),分别。此外,在AUCREF的10%以内的患者百分比,定义为|贝叶斯估计AUC-AUCREF| An administration plan for vancomycin (VCM) in bedridden elderly patients has not been established. This retrospective study aimed to evaluate the prediction accuracy of the area under the concentration-time curve (AUC) of VCM by the Bayesian approach using creatinine-based equations of estimated kidney function in such patients. Kidney function was estimated using the Japanese equation of estimated glomerular filtration rate (eGFR) and the Cockcroft-Gault equation of estimated creatinine clearance (eCCr). eCCr (serum creatinine (SCr) + 0.2) was calculated by substituting the SCr level +0.2 mg/dL into the Cockcroft-Gault equation. For eGFR/0.789, eGFR, eCCr, and eCCr (SCr + 0.2), the AUC values were calculated by the Bayesian approach using the therapeutic drug monitoring (TDM) software, BMs-Pod (ver 8.06) and denoted as AUCeGFR/0.789, AUCeGFR, AUCeCCr, and AUCeCCr (SCr + 0.2) respectively. The reference AUC (AUCREF) was calculated by applying VCM\'s peak and trough steady-state concentrations to first-order pharmacokinetic equations. The medians (range) of AUCeGFR/0.789/AUCREF, AUCeGFR/AUCREF, AUCeCCr/AUCREF, and AUCeCCr (SCr + 0.2)/AUCREF were 0.88 (0.74-0.93), 0.90 (0.79-1.04), 0.92 (0.81-1.07), and 1.00 (0.88-1.11), respectively. Moreover, the percentage of patients within 10% of the AUCREF, defined as |Bayesian-estimated AUC - AUCREF| < AUCREF × 0.1, was the highest (86%) in AUCeCCr (SCr + 0.2). These results suggest that the Bayesian approach using eCCr (SCr + 0.2) has the highest prediction accuracy for the AUCREF in bedridden elderly patients. Although further studies are required with more accurate determination methods of the CCr and AUC, our findings highlight the potential of eCCr (SCr + 0.2) for estimating VCM\'s AUC by the Bayesian approach in such patients.
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