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Reliability of Glomerular Filtration Rate Estimated by Creatinine-Based Formulas in Moderate to Severe Proteinuria
Clinical Journal of the American Society of Nephrology ( IF 8.5 ) Pub Date : 2024-10-24 , DOI: 10.2215/cjn.0000000602
Carmine Zoccali, Fabio Pasquale Provenzano, Giovanni Tripepi, Fabiola Carrara, Francesca Mallamaci, Annalisa Perna, Pierre Delanaye, Pietro Ruggenenti, Giuseppe Remuzzi

on. Methods: We utilized data from the Ramipril in non-diabetic renal failure (REIN 1) and REIN 2 trials involving non-diabetic chronic kidney disease (CKD) patients with proteinuria to compare eGFRs derived from the CKD Epidemiology Consortium (CKD-EPI)formulas (with and without race), and the European Kidney Function Consortium (EKFC) equations with iohexol clearance (a gold-standard GFR measure, measured glomerular filtration rate [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 to 0.05 ml/ml/min/1.73m2) in the REIN 1 study and (-0.04 to -0.03 ml/min/1.73 m2) in the REIN 2 study. 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 REIN 1 and all strata in REIN 2, but the mGFR stratum <15 ml/min/1.73m2. Conclusion: The CKD-EPI (with and without race), and EKFC equations show no significant bias and sufficient accuracy in patients with proteinuria. These formulas can be safely applied to non-diabetic CKD patients with moderate to severe proteinuria. Copyright © 2024 by the American Society of Nephrology...

中文翻译:


中度至重度蛋白尿中基于肌酐的公式估计的肾小球滤过率的可靠性



上。方法:我们在非糖尿病肾功能衰竭 (REIN 1) 和 REIN 2 试验中利用雷米普利的数据,涉及非糖尿病慢性肾脏病 (CKD) 蛋白尿患者,以比较源自 CKD 流行病学联盟 (CKD-EPI) 公式的 eGFR(有和没有种族),以及欧洲肾功能联盟 (EKFC) 方程与碘海醇清除率(一种金标准 GFR 测量, 测量的肾小球滤过率 [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,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数偏差没有差异,在 REIN 1 研究中最小且在严格范围内 (0.04 至 0.05 ml/ml/min/1.73m2) 和 (-0.04 至 -0.03 ml/min/1.73 m2) 在 REIN 2 研究中。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度在 REIN 1 和 REIN 2 的所有层中显示出足够的准确度 (P30 >75%),但 mGFR 层 <15 ml/min/1.73m2。结论: CKD-EPI (有和没有种族)和 EKFC 方程在蛋白尿患者中显示无显著偏倚和足够的准确性。这些配方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。美国肾脏病学会版权所有 © 2024...
更新日期:2024-10-24
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