Selecting appropriate evaluation equations for assessing declining kidney function in aging individuals with disease conditions
Objective To compare the performance of 11 glomerular filtration rate(GFR)equations in Chinese elderly hospitalized patients using dynamic renal imaging as the reference standard.Methods The retrospective study involved patients aged 60 years and older who were admitted to Beijing Hospital between January,2017,and January 2020.Glomerular filtration rate(GFR)was assessed through dynamic renal imaging for all participants.Estimated GFR(eGFR)was calculated using various equations based on serum creatinine and/or cystatin C levels,including All Age Spectrum(FAS),Berlin Initiative Study(BIS),Chronic Kidney Disease Epidemiology Collaboration(CKD-EPI),Modification of Diet in Renal Disease Study(MDRD),MDRD in China(MDRDc),and Xiangya..Results A total of 691 patients,of which 383 were males,with an age range of 60 to 90 years(mean age 71.9±7.7 years),were included in the study.Among the different equations used to estimate glomerular filtration rate(GFR)in ml·min-1·1.73m-2,the smallest deviations were observed with FAScys(2.48),FAScr-cys(3.07),CKD-EPIcys(4.20),and BIScr-cys(7.42).Conversely,the most accurate estimations were found with BIScr-cys(10.38),FAScr-cys(11.94),FAScys(12.08),CKD-EPIcr-cys(13.21),and CKD-EPIcys(13.51).The highest P30 values,indicating the proportion of estimates within 30％of the true GFR,were achieved by FAScr-cys(68.97％),FAScys(68.96％),CKD-EPIcys(63.22％),and BIScr-cys(61.67％).The equations with the lowest root mean square errors were BIScr-cys(9.73),CKD-EPIcr-cys(10.98),FAScr-cys(11.27),CKD-EPIcys(11.52),and FAScys(11.53).Specifically,the FAS equation showed higher accuracy in men,while BIScr-cys and CKD-EPIcys were more accurate in women.Among patients with chronic kidney disease(CKD),the P30 values for BIScr-cys,FAScys,and FAScr-cys were 86.96％,83.33％,and 80.95％respectively.Notably,for patients with mGFR ≥ 30 ml/min,MDRDc overestimated GFR the most,whereas for patients with mGFR＜30 ml/min,Xiangya exhibited the most significant overestimation of GFR.Conclusions Among the equations tested,BIScr-cys,FAScys,and FAScr-cys demonstrated the highest accuracy and are therefore recommended for use in Chinese elderly hospitalized patients.
Renal function assessmentDynamic renal imagingeGFR equationsElderly patients
万方数据
维普
