ondiabetic renal failure 1 and 2 trials.The CKD Epidemiology Collaboration 2009 and 2021 and European Kidney Function Consortium equations show no significant bias and sufficient accuracy in moderate-to-severe proteinuria. Background Creatinine-based GFR formulas introduce a substantial bias in GFR estimations in patients with frank nephrotic syndrome. The bias and accuracy of creatinine-based GFR estimates (eGFR) in patients with non-nephrotic proteinuria need better characterization. Methods We used data from the Ramipril in Nondiabetic Renal Failure (ramipril in nondiabetic renal failure [REIN] 1) and REIN 2 trials involving nondiabetic CKD patients with proteinuria to compare eGFRs derived from the CKD Epidemiology Collaboration formulas (with and without race) and the European Kidney Function Consortium equations with iohexol clearance (a gold-standard GFR measure, measured GFR [mGFR]). Bias was defined as the median difference between eGFR and mGFR while accuracy was assessed using P30 and P15 metrics, which represent the percentage of eGFR values within ±30% and ±15% of mGFR, respectively. Results The median bias of the three formulas being compared did not differ, being minimal and in a strict range (0.04–0.05 ml/ml per min per 1.73 m2) in the REIN 1 trial and (−0.04 to 0.03 ml/min per 1.73 m2) in the REIN 2 trial. These findings were confirmed in analyses stratified by age and mGFR. The global accuracy of the three formulas regarding P30 % showed sufficient accuracy (P30 >75%) in the REIN 1 trial and all strata in the REIN 2 trial, but the mGFR stratum was <15 ml/min per 1.73 m2. Conclusions The CKD Epidemiology Collaboration (with and without race) and European Kidney Function Consortium equations show no significant bias and sufficient accuracy in patients with proteinuria. These formulas can be safely applied to nondiabetic CKD patients with moderate-to-severe proteinuria. Clinical Trial registry name and registration number: This is a post hoc analysis of two trials, REIN 1 and 2, published about 20 years ago....

中文翻译：

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通过基于肌酐的公式估计的中度至重度蛋白尿 GFR 的可靠性


糖尿病肾功能衰竭 1 和 2 试验。2009 年和 2021 年 CKD 流行病学协作以及欧洲肾功能联盟方程式显示，在中度至重度蛋白尿中，无显著偏倚且准确性足够。背景 基于肌酐的 GFR 公式在明显肾病综合征患者的 GFR 估计中引入了很大的偏倚。非肾病性蛋白尿患者基于肌酐的 GFR 估计 （eGFR） 的偏倚和准确性需要更好的表征。方法 我们使用雷米普利治疗非糖尿病性肾功能衰竭 （雷米普利治疗非糖尿病肾衰竭 [REIN] 1） 和 REIN 2 试验的数据，涉及非糖尿病 CKD 蛋白尿患者，以比较源自 CKD 流行病学协作公式（有和无种族）和欧洲肾功能联盟方程的 eGFR 与碘海醇清除率（金标准 GFR 测量， 测量的 GFR [mGFR]）。偏倚定义为 eGFR 和 mGFR 之间的中位数差异，而准确性使用 P30 和 P15 指标进行评估，P30 和 P15 指标分别代表 eGFR 值在 mGFR 的 ±30% 和 ±15% 范围内的百分比。结果被比较的三个公式的中位偏倚没有差异，在 REIN 1 试验中最小且处于严格范围内（0.04-0.05 ml/ml/min/1.73 m2），在 REIN 2 试验中（-0.04 至 0.03 ml/min/1.73 m2）。这些发现在按年龄和 mGFR 分层的分析中得到了证实。关于 P30 % 的三个公式的总体准确性在 REIN 1 试验和 REIN 2 试验中的所有层中显示出足够的准确性 （P30 >75%），但 mGFR 层为 <15 ml/min/1.73 m2。 结论 CKD 流行病学协作 （有和无种族） 和欧洲肾功能联盟方程组显示蛋白尿患者无显著偏倚且准确性足够。这些公式可以安全地应用于患有中度至重度蛋白尿的非糖尿病 CKD 患者。临床试验注册名称和注册号：这是对大约 20 年前发表的两项试验 REIN 1 和 2 的事后分析。