1.Evaluation of 5 formulas for estimated glomerular filtration rate forassessment of renal filtration function in clinical applica-tion
Mindong MI ; Jiyong GONG ; WeiJie SUN ; Wei LIANG
Chinese Journal of Clinical Laboratory Science 2024;42(6):456-460
Objective To evaluate the clinical application value of the 5 estimated glomerular filtration rate(eGFR)formulas,inclu-ding MDRD,MDRD Chinese formula[MDRDCHN],CKD-EPICr,CKD-EPICysC and CKD-EPICr-CysC,in assessing glomerular filtration function and diagnosing chronic kidney disease(CKD),and determine the most suitable formula for the local region.Methods A to-tal of 2 610 outpatients and inpatients from The First Affiliated Hospital of Ningbo University were enrolled as the study subjects.Serum creatinine(Cr)and CysC levels were measured,and eGFR was estimated using the 5 formulas.The differences of eGFR values calcu-lated by different formulas were compared.In 412 inpatients,the correlations between endogenous creatinine clearance rate(cCr)and the 5 eGFR results were analyzed,and ROC curves were plotted to compare the diagnostic efficacy of the five eGFR values for CKD.The reference interval for eGFR was established using data from 239 healthy individuals.Results All the eGFR values calculated by the 5 formulas showed skewed distributions and differences of most pairwise comparisons were statistically significant.All the 5 eGFR values were significantly positively correlated with cCr.The CKD-EPICrCysC showed the highest correlation coefficient(r=0.903).The areas under the ROC curves for diagnosing CKD using the 5 eGFR formulas were 0.968,0.969,0.970,0.967 and 0.976,respectively.CKD-EPICr-CysC showed the best diagnostic performance(sensitivity of 97.3%,specificity of 89.8%).The lower limits of the 95%confi-dence interval for healthy individuals were 76,87,82,99,and 93 mL/min/1.73m2 for the different formulas respectively.Conclusion Among the five eGFR formulas,CKD-EPICr-CysC with a reference interval lower limit of 93 mL/min/1.73m2 was demonstrates as the best diagnostic efficiency for assessing glomerular filtration function and diagnosing CKD,and is worth promoting and applying in Ning-bo region.