ABSTRACT
Objective To evaluate whether three chronic kidney disease epidemiology collaboration (CKD-EPI) equations (CKD-EPI2009Scr,CKD-EPI2012SCysC and CKD-EPI2012Scr-SCysC) are applicable in the prediction of glomerular filtration rate (GFR) in Chinese patients with diabetic nephropathy (DN).Methods One hundred and eight patients with DN who were hospitalized in the First Affiliated Hospital of Guangzhou Medical University with GFR being measured by dynamic renal imaging with 99mTc-DTPA from June 2012 to April 2014 were enrolled in this study.GFR measured by dynamic renal imaging with 99mTe-DTPA was used as the reference value (rGFR).GFR was estimated by the CKD-EPI2009Scr equation,the CKD-EPI2012SCySC equation,and the CKD-EPI2012Scr-SCysC equation (labeled as eGFR1,eGFR2,eGFR3).The correlation,30％ accuracy,staging consistency,deviation and diagnostic accuracy were compared among the three CKD-EPI equations.Results The rGFR in 108 DN patients was (61.78±26.51) ml· min-1· (1.73 m2)-1.The correlation between three eGFRs and rGFR was significant (all P ＜ 0.01),the correlation coefficients were 0.738,0.708,0.782.The 30％ accuracy were 74.07％,52.78％,67.59％,The 30％ accuracy of eGFR1 and eGFR3 were higher than eGFR2 (all P ＜ 0.05),but there was no significant difference between eGFR3 and eGFR1 (x2=0.874,P=0.436).The staging consistency was not ideal,Kappa values were 0.391,0.180 and 0.422.For the deviations between three eGFRs and rGFR,there was no significant difference between eGFR3 and rGFR (P ＞ 0.05),eGFR1 underestimated rGFR,eGFR2 overestimated rGFR (all P ＜ 0.01).The results of the Bland-Altman chart showed that consistencies between three eGFRs and rGFR were poor,the degree of deviation of eGFR3 was the smallest.The area under the ROC curve (AUC) of three eGFRs was 0.878,0.883 and 0.915.The AUC,sensitivity,specificity,overall compliance rate and Youden index of eGFR3 were the highest.Conclusions The eGFRs predicted by the three CKD-EPI equations showed good relevance,accuracy and diagnostic accuracy with the rGFR,but poor in consistencies.Comparatively,CKD-EPI2012Scr-SCysC may be better than others,but its consistency limits exceeds the acceptable limits.Therefore,the applicability of using the three CKD-EPI equations to predict the GFR in Chinese DN patients requires a larger sample and multiple verifications as well as further improvement.
ABSTRACT
Objective To explore the clinical significance of urine trace albumin in early diagnosis of diabetic nephropathy(DN). Methods A total of 35 patients with DN in DN group,32 patients with type 2 diabetes mellitus (DM)in DM group and 36 people accepted physical examination in control group.The urine trace albumin,blood urea nitrogen,serum creatinine were detected and compared.Results Urine trace albumin level in DN group was significant higher than those of DM group and control group,the differences were statistical significant(P 0.05).The urine trace albumin,blood urea ni-trogen and serum creatinine between DM group and control group had no statistical significant differences (P >0.05).Conclusion Urine trace albumin could be used as an early diagnostic index for early diagnosis of DN.
ABSTRACT
Objective To examine the change and role of nuclear factor-kappa B(NF-?B) activity and tumor necrosis factor-alpha(TNF-?) level in patients with systemic inflammatory response syndrome(SIRS).Methods Eighty patients with SIRS were studied.The NF-?B activity in monocytes and the level of TNF-? in serum was measured.The state of illness was estimated by APACHEⅡ score.Results There was significant difference for the activity of NF-?B in patients with SIRS compared with the control group.The NF-?B activity,TNF-? level and APACHEⅡ score are higher in both resuscitation multiple organ dysfunction syndrome(MODS) group and death group than the non-MODS group and survival group correspondingly(P