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Estimating Performance of CG and Re-expressed MDRD Equations in Patients with Chronic Kidney Disease

Author: FengXinHui
Tutor: YeZhiBin;ShengWeiWen;YanZhenWen;ZhangXiaoLi
School: Fudan University
Course: Internal Medicine
Keywords: Cockcroft-Gault equation Abbreviated MDRD equation Glomerular filtration rate
CLC: R692
Type: Master's thesis
Year: 2010
Downloads: 46
Quote: 1
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Abstract


Purpose Cockcorft-Gault equation (CG equation) and simplify the MDRD (Modification of Diet in Renal Disease) equation is widely used to estimate the adult CKD patients with glomerular filtration rate (GFR), this study explores the different CKD patients CG equation and the simplified MDRD equation the estimation deviation and application value. Methods 2006-2009 Huadong hospital 581 cases CKD patients using 99mTc-DPTA GFR (the estimation results TGFR) was measured over the same period of serum creatinine, respectively, according to the CG equation to correct the CG equation, abbreviated MDRD equation improve the simplified the MDRD the equation (rMDRD equation), simplify MDRD equation (cMDRD equation) for Chinese CKD patients improved estimation of GFR (the results of the estimation of CG-Ccr, CG-GFR, the MDRD-GFR rMDRD-GFR, cMDRD -GFR), analysis in different CKD patients, the GFR estimating equation estimates of 99mTc-DPTA the GFR measurement value measured deviation, precision and accuracy of the difference. The CKD patients by gender into male group and female group, divided into male elderly by sex and age group, male non-elderly group, women old age group, women non-elderly group is divided into single-kidney group difference by sub-renal, sub-renal There are significant differences between groups (one side of the renal function stars renal function for the other side of 20% or less), and divided by age, age group, and the non-elderly groups, analysis of gender, age, stars renal functional differences and other factors estimation deviation the impact. In non-single-kidney group, gender group, single-kidney renal function. Significant differences between groups, senior citizens groups, and explore the use of data conversion and the use of the deviation of the estimates of the regression equation, further assessment of the value of the estimating equation. Results ① 559 cases of non-single kidney patients, correction of the predictive ability of the CG equation is slightly better than the other equation, abbreviated MDRD equation 15% accuracy rate in the other equation rMDRD equation 30% accuracy rate in the other equation, 50% of the CG equation high accuracy in the other equation, linear regression results show that the correction of the estimate of the CG equation correlation is better than other equations. (2) in male patients with CKD, rMDRD equations predictive ability is better than the other equation, the CG equation 15% accuracy rate in the other equation, rMDRD equation 30% accuracy rate in the other equation, 50% of the high accuracy of the CG equation and corrected CG equation in other equations. The linear regression results show that the correction CG equation estimate than other equation. In female patients with CKD, the correction the CG equation predictive ability is better than other equation the rMDRD equation 15% accuracy rate in the other equation, abbreviated MDRD equation 30% accuracy rate in the other equation, 50% accuracy rate correction CG equation and rMDRD equation higher than the other equations. The linear regression results show that the correction CG equation estimate than other equation. (3) male elderly (≥ 65 years of age) CKD patients, the the CG equation predictive ability is better than other equation, CG equation and simplified MDRD equation 15% accuracy rate in the other equation, CG Equation 30 percent accuracy rate is higher than the other equations 50% accuracy rate in other equations corrected CG equation. The linear regression results show that the correction CG equation estimate than other equation. Male non-elderly (age lt; 65-year-old) CKD patients, the predictive ability of the simplified MDRD equation better than the other equation, the CG equation 15% accuracy rate in other equations rMDRD equation 30% accuracy rate in the other equation, CG equation 50% accurate and simplified MDRD equation is higher than the other equations. Linear regression analysis showed that simplify MDRD equation and rMDRD equation estimate correlation than other equation. Female elderly patients with CKD, the the CG equation predictive ability is better than the other equations the rMDRD Equation 15 percent accuracy rate in the other equation to simplify MDRD equation and rMDRD of equation 30% accuracy rate in other equations, correction CG the equation and rMDRD of equation 50 % accuracy rate in the other equation. The linear regression results show that the correction CG equation estimate than other equation. Female non-elderly patients with CKD, rMDRD equation predictive ability is better than the other equation, 15% of rMDRD equation with high accuracy in the other equation, abbreviated MDRD equation 30% accuracy rate in the other equation, 50% accurate correction CG the equation and rMDRD of equation higher than the other equations. Linear regression analysis showed that simplify MDRD equation and rMDRD equation estimate correlation than other equation. (4) in 22 cases of patients with a single kidney, correction predictive ability of the CG equation is better than the other equations rMDRD equation 15% accuracy rate in the other equation, abbreviated MDRD equation 30% accuracy rate in the other equation, the CG equation 50% accuracy rate in other equations. Stars of renal function in 23 patients, a significant difference (stars renal function on one side stars for the other side of 20% or less) of the renal function in patients with CKD and the predictive ability of the simplified MDRD equation in the other equations, the CG equation 15% accuracy rate in other equations, corrected CG equation 30% accuracy rate in the other equation, 50% accuracy rate in other equations corrected CG equation. Significant differences in the single kidney and sub-renal patients with CKD correction CG equation predictive ability is better than the other equations, correction CG equation estimation accuracy is better than the other equations. The accuracy comparison the CG equation 15% accuracy rate in other equations corrected CG equation and simplified MDRD equation 30% accuracy rate in the other equation, 50% accuracy rate in other equations corrected CG equation. The linear regression results show that the correction of the estimate of the CG equation correlation is better than other equations. (6) in the elderly CKD patients ≥ 75 years of age, the predictive ability of the CG equation better than the other equations the, rMDRD equation 15% accuracy, 30% accuracy rate in the other equation, 50% accuracy rate in other equations corrected CG equation. Linear regression analysis showed that simplify MDRD equation and rMDRD equation estimate correlation than other equation. Conclusion ① single kidney patients with CKD, a different gender CKD patients, as well as a different gender, age group, patients with CKD correction CG equation underestimated TGFR. ② On the whole, the non-single-kidney group, correcting CG equation advantages of rMDRD equation estimation is higher than the other equations; male group, rMDRD equation is better than the other equations; female group, the correction CG equation and rMDRD of equations to be better than the other equations; male elderly group the CG the equation and rMDRD of equation better than the other equations; non-elderly group of men, to simplify MDRD equation and rMDRD of equation better than the other equations; the female older group the, rMDRD equation better than the other equations; women non-elderly group the, rMDRD equation better than the other equations; single kidney and renal function of the significant differences between groups, corrected CG equation is superior to other equations; age group, rMDRD equation is better than the other equations. ③ After the data is converted, non-single-kidney group, different gender groups, senior citizens groups, correction the CG equation estimation is superior to other equations.

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CLC: > Medicine, health > Surgery > Urology ( urinary and reproductive system diseases) > Kidney disease
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