Application of estimation equations for glomerular filtration rate intype 2 diabetes mellitus / 中国医学影像技术

ABSTRACT

Objective To investigate the application value of chronic kidney disease epidemiology collaboration (CKD-EPI) equations and amendatory equations for calculating glomerular filtration rate (GFR) in Chinese patients with diabetes,including CKD-EPI serum creatinine (Scr) equation (CKD-EPLcr),CKD-EPI serum cystatin C (ScysC) equation (CKD-EPLcysc),combination of CKD-EPLcr and CKD-EPIScrSCysC (CKD-EPISr SCysC),Asian modified CKD-EPI equation (CKD-EPIAsian),Chinese diabetes CKD-EPI equation (CKD-EPIDiabctes),refitted modification of diet in renal disease (MDRD) equation (rMDRD),Cockcroft-Gault equation (CG) and Simplified MDRD equation.Methods Serum creatinine (Scr) was detected using basic picric acid method,serum cystatin C (CysC) was measured by Latex enhanced turbidimetric,and the reference value of GFR was worked out by 99Tcm-DTPA renal dynamic imaging and standardization of body surface area.Relation of Scr,Scysc,GFR measured by every equations and rGFR were analyzed.The accuracy of 30％ of each equation,the consistency and deviation of the evaluation of renal function by each equation were compared.The diagnostic efficacy in GFR＜60 ml/(min · 1.73 m2) was compared using the receiver operating characteristic (ROC) curve.Results The rGFR had negative correlation with Scr、ScysC (both P＜0.001).The rGFR had positive correlation with GFR measured by CKD-EPIScr,CKD-EPIScysC,CKD-EPIS-SCysC,CKD-EPIAsian,CKD-EPIDiabetes rMDRD,CG and Simplified MDRD (all P＜0.001).The coincidence rate between 30％ of rGFR and GFR measured byCKD-EPIDiabetes and simplified MDRD were higher.There was no significant difference of rGFR and GFR measured by CKD-EPIscr,CKD-EPIScysC,CKD-EPIScr-SCysC,CKD-EPIAsian,CKD-EPIDiabetes,rMDRD,CG and Simplified MDRD.GFR measured by CKD-EPIDiabetes has the best consistent degree with rGFR.ROC curve showed that the area under curve of GFR measured by CKD-EPIDiabctes was largest and the Youden index was the highest.Conclusion There are different degrees of deviation in eGFR predicted by the eight kinds of equations.The accuracy and consistency of CKD-EPIDiabetes in Chinese 2-type diabetes is the best.