ABSTRACT
Objective To compare the estimated CFR (eCFR) values using the new chronic kidney disease epidemiology collaboration (CKD-EPI) equation with those from the abbreviated MDRD equation in a Chinese cohort with chronic kidney disease (CKD) and to analyze the impact of the new CKD-EPI equation on the staging of CKD. Methods A total of 450 Chinese patients (239 female and 211 male) with CKD were enrolled. eCFRs obtained by the CKD-EPI equation and the abbreviated MDRD equation were compared with the Bland and Altaian method. The agreement between two equations in CKD staging was assessed by Kappa test. Results Mean eGFR was 2.4 ml ·(min)-1 ·( 1.73 m2)-1 higher with the CKD-EPI equation as compared to the abbreviated MDRD equation. The percentage of CKD staging concordance between equations for stage 1, 2, 3A, 3B, 4, and 5 was 97.10% (n=67), 80.77% (n=105), 6 0.86% (n= 48), 87.69%(n=57), 90.38% (n=47) and 98.18% (n=54) respectively. Kappa index was 0.913 (95%C/: 0.881-0.945). The CKD-EPI equation reclassified 19.23% (n=25) and 39.24% (n=31) of patients with CKD stage 2 and 3A,upward to a higher eCFR category. Conclusions The new CKD-EPI equation reclassifies a number of patients to higher CKD stages, especially those classified as CKD stage 2 or 3A by the abbreviated MDRD equation.
ABSTRACT
Objective To determine the relationship between zinc and nutritional status or immunity in patients with end-stage renal disease undergoing continuous ambulatory peritoneal dialysis (CAPD). Methods Forty-five stable CAPD patients undergoing peritoneal dialysis were enrolled in this study. The dietary zinc intake and serum zinc levels were investigated, and the results were compared with the gender- and age-matched healthy populations (n = 45). The relationship between dietary zinc intake and serum zinc levels and subjective global assessment (SGA) score, blood cell counts, serum albumin (ALB), prealbumin (PA), C-reactive protein (CRP),and lymphocyte subsets were analyzed. Results The percentages of inadequate dietary zinc intake (P= 0. 007)and low blood zinc (P = 0. 036) were significantly higher in CAPD patients than in healthy group. CD8 levels were significantly lower (P = 0. 000) while CD4/CD8 ratio was significantly higher (P = 0. 033) in CAPD patients than in healthy group. In CAPD patients, correlation analysis showed that dietary zinc intake was significantly correlated with serum prealbumin levels (r = 0. 577, P = 0. 000), but was negatively correlated with SGA score (r = - 0.354,P = 0. 015) and CRP (r = - 0.354, P = 0. 015); however, it was not significantly correlated with lymphocyte subsets and CD4/CD8 ratio. Serum zinc level was significantly positively correlated with hemoglobin (r= 0. 411, P=0.005), hematocrit (r=0.345, P=0.023), WBC (r=0.318, P=0.035), SGA score (r=0.417, P=0. 005), and CRP (r=0.342, P = 0. 027), but was not significantly correlated with lymphocyte subsets and CD4/CD8 ratio. Conclusions Zinc deficiency is common among patients with CAPD. Adequate dietary zinc intake can facilitate protein synthesis and improve the overall nutritional status. High serum zinc concentrations are beneficial for the synthesis of hemoglobin and the improvement of anemia.