On Clinical Utility Of Diverse Glomerular Filtration Rate Evaluation Equations In Chronic Kidney Disease Patients

Objective： To evaluate clinical utility of diverse glomerular filtration rate evaluationequations in chronic kidney disease patients of Dalian.Method： Taking99mTc-DTPA renal dynamic imaging as the GFR reference value(rGFR obtained) of CKD patients, employing picric acid method for the determinationof serum creatinine concentration, using liquid immune colloidal gold technique todetect plasma cystatin C concentration, we respectively apply of Cockcroft-Gaultequation, MDRD simplified equation, the MDRD equation modified by the Chinese,the CKD epidemiology collaborative research (CKD-EPI) equation, a series ofcystatin C-based GFR assessment equation （Hoek， Larsson， Orebro， Grubb，Rule， Chinese eGFR cooperative group， Stevens LA）,2006Chinese formula andthe equation combining with serum creatinine and cystatin C developed by ChineseeGFR research group in2007for the acquisition of estimated GFR (eGFR); wecompare difference of eGFR and rGFR in creatinine-based assessment equation eGFR,in evaluation equation of the cystatin C-based eGFR and in the two equationsseparately.Results：1. Related Evaluation: we correlatively analyze the eGFR calculated by glomerularfiltration rate assessment equation of36patients and GFR measured by99mTc-DTPA renal dynamic imaging, r results were CG-GFR formula:0.841,MDRD formula:0.835, MDRD simplified formula:0.813, modified MDRDformula1:0.813Chinese population, the Chinese population modified MDRDformula2:0.802, the CKD-EPI equation:0.725, Hoek:0.861Larsson:0.846,Orebro:0.861, Grubb:0.815, Rule:0.852,2007China eGFR collaborative groupcystatin C equation:0.854, Stevens LA:0.8512006United creatinine, cystatin CChinese formula:0.848,the the2007Chinese eGFR collaborative group creatinine joint cystatin C equation1:0.859. All r values are greater than0.7,indicating that all eGFR measured by glomerular assessment equationsignificantly correlate with GFR measured by99mTc-DTPA renal dynamicimaging method.2. Evaluation of the differences: Taking GFR values measured by99mTc-DTPArenal dynamic imaging as a standard reference, CKD stages of all glomerularfiltration rate assessment equation showed no significant difference of theChinese modified MDRD formula1: In CKD1, the CG-GFR formula and theMDRD equation of patients are underestimated; in CKD2, Hoek, Larsson, Grubb,Rule, Chinese eGFR collaboration group, Stevens LA in patients are allunderestimated; In CKD3, the EPI equation of patients is overestimated, theChinese improved MDRD formula was no significant difference, and the rest ofthe glomerular filtration rate equations are underestimated; in CKD4, Grubbequation of patients is underestimated and the EPI equation overestimated.Conclusions：1. The GFR estimated value measured by MDRD equation modified by the Chineseshowed no significant difference from the rGFR values measured with99mTc-DTPA renal dynamic imaging method in terms of relevance, accuracy andstaging accuracy.2. In CKD1and CKD4, takinge rGFR values measured by99mTc-DTPA renaldynamic imaging as a standard reference, there exist few differences in glomerularfiltration rate assessment equation; while in CKD3, in addition to the MDRDequation modified by the Chinese, others all show differences with the rGFRvalue measured with99mTc-DTPA renal dynamic imaging method.