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歷 年 稿 件 內 容
 
*類別：
* 姓名： 趙恒立
投稿種類：
*中文投稿標題： 比較CKD-EPI與MDRD equations用於評估GFR之年齡層影響差異
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* 投稿摘要： Estimation of GFR using the Modification of Diet in Renal Disease (MDRD) equation underestimates measured GFR at higher levels (above 60 mL/min/1.73 m2) and thus over estimates CKD. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) developed a new equation which has been shown to reduce bias in comparison to the MDRD equation but the impact of age has not been assessed. The aim of this study was to evaluate the difference of estimated GFR between the MDRD with the CKD-EPI equation in the CKD 1-2 stage, particularly at the impact of ages. Patients and methods: Analysis of a random sample of 434 patients from the general population aged 12-92 years without known kidney disease. Results: In the validation data, the CKD-EPI performed better than the MDRD equation at higher GFR, with less bias (median difference between measured and estimated GFR, 2.8 vs. 5.1 mL/min/1.73 m2) (p<0.001), and improved accuracy(percentage of estimated GFR within 30 % of measured GFR, 81.0% vs.76.8%). Overall the median measured GFR was 87.1(IQR 105.6-73.4); the median estimated GFR, the CKD-EPI was 84.3 (IQR 98.2-68.7) and the MDRD was 82 (IQR 96.5-67.0) mL/min/1.73 m (kappa 0.859; p<0.001). In all age groups the median estimated GFR fell with age and the agreement in GFR stage categories as measured by the Kappa statistic. Median the CKD-EPI GFR(IQR)/Median the MDRD GFR(IQR) stratified by age has presented as follows: <30 ages：93.1(108.0-79.0)/87.5 (117.5-83.8), kappa 0.786; 30-39 ages：95.2(111.4-75.0)/88.0(102.0-70.5),kappa 0.864; 40-49 ages：90.0(107.2-75.2)/84.0(98.0-71.0),kappa 0.729; 50-59 ages：84.4(99.2-71.8)/82.0 (95.0-69.0),kappa 0.986; 60-69 ages：77.0(91.1-56.9)/77.0(91.0-59.0),kappa 0.931; >70 ages： 73.3(86-58.2)/75.0(86.0-60.0),kappa 0.708, all the agreement analysis p<0.001. Conclusion: Compared with the MDRD, the CKD-EPI equation generates higher GFR and lower CKD estimates. However, at ages >50 there is very little difference between CKD-EPI and MDRD, and among the very elderly CKD-EPI may actually increase estimates of CKD.
*關鍵字1 ： CKD-EPI
*關鍵字2 ： MDRD equations
*關鍵字3 ： GFR
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* 服務機關：
* 第一作者： 趙恒立
* 身分字號： *****89971
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