Background: Kidney disease, even when mild, was once considered so major an impediment to successful pregnancy and so dangerous to the mother’s wellbeing. High-risk pregnancy mainly associated to renal impairment may...Background: Kidney disease, even when mild, was once considered so major an impediment to successful pregnancy and so dangerous to the mother’s wellbeing. High-risk pregnancy mainly associated to renal impairment may occur in 10-20% of gestations and it is very important that renal function is closely monitored to prevent or minimize maternal and fetal complications. This study was designed to investigate the performance of Cockcroft-Gault CGeq and the simplified MDRDeq equations in healthy pregnant women to assess renal function. Methods: We studied 167 normal ambulatory pregnant women and kidney function was contemporaneously estimated through the CGeq and the simplified MDRDeq and calculated through the creatinine clearance (Ccr). Serum and urinary creatinine were assayed using Jaffé reaction method in the same AutoAnalyser. Results: When we compared calculated and estimated clearences for measurement of kidney function we observed that CGeq overestimated renal function (CGeq = 168.41 ± 38.80 ml/ min/1.73 m2, Ccr = 146.27 ± 30.49 ml/min / 1.73 m2, p < 0.001), MDRDeq underestimated renal function (Ccr = 146.27 ± 30.49 ml/min / 1.73 m2, MDRDeq = 129.15 ± 29.28 ml/min / 1.73m2, p < 0.001). Conclusions: Our results demonstrated that CGeq overestimated, MDRDeq underestimated significantly kidney function during gestation in healthy women and cannot be recommended to assess renal function in obstetric practice. Ccr remains a useful clinical tool in pregnant women until the development of a specific equation that considers the several important maternal renal physiological alterations and provides the measure of GFR the most unbiased and precise as possible.展开更多
目的:以99mTc-DPTA血浆清除率为标准,对24h内生肌酐清除率(Ccr)、Cockcroft-Gault(CG)方程和简化MDRD(modification of diet in renal disease)方程进行比较,评价三种方程在慢性肾脏疾病(CKD)患者中的应用。方法:选择139例各种慢性肾脏...目的:以99mTc-DPTA血浆清除率为标准,对24h内生肌酐清除率(Ccr)、Cockcroft-Gault(CG)方程和简化MDRD(modification of diet in renal disease)方程进行比较,评价三种方程在慢性肾脏疾病(CKD)患者中的应用。方法:选择139例各种慢性肾脏疾病患者,将Ccr、CG方程和简化MDRM方程估算的肾小球滤过率(GFR)用体表面积(BSA)标准化,与BSA标准化的99mTc-DTPA测得的GFR(99mTc-GFR)在不同CKD分期进行比较。结果:CKD第一至第五期:Ccr与99mTc-GFR相关系数r分别为:0.79、0.71、0.64、0.59、0.52;Ccr在ROC曲线下面积平均为0.79。CG-GFR与99mTc-GFR相关系数r分别为:0.85、0.78、0.72、0.67、0.61;CG-GFR在ROC曲线下面积平均为0.83。MDRD-GFR与99mTc-GFR相关系数r分别为:0.83、0.76、0.69、0.65、0.59;MDRD-GFR在ROC曲线下面积平均为0.82。在CKD不同分期三种方程的GFR估算值与99mTc-GFR差异均有显著意义(P均<0.001)。结论:三种方程的GFR估算值与99mTc-GFR均有较好的相关性和ROC曲线下面积,以CG方程最好,其次为简化MDRD方程,Ccr最低,但三种方程估算值与99mTc-GFR测定值差异均有显著意义。上述方程直接应用于我国CKD患者时,应对其进行适当修正。展开更多
文摘Background: Kidney disease, even when mild, was once considered so major an impediment to successful pregnancy and so dangerous to the mother’s wellbeing. High-risk pregnancy mainly associated to renal impairment may occur in 10-20% of gestations and it is very important that renal function is closely monitored to prevent or minimize maternal and fetal complications. This study was designed to investigate the performance of Cockcroft-Gault CGeq and the simplified MDRDeq equations in healthy pregnant women to assess renal function. Methods: We studied 167 normal ambulatory pregnant women and kidney function was contemporaneously estimated through the CGeq and the simplified MDRDeq and calculated through the creatinine clearance (Ccr). Serum and urinary creatinine were assayed using Jaffé reaction method in the same AutoAnalyser. Results: When we compared calculated and estimated clearences for measurement of kidney function we observed that CGeq overestimated renal function (CGeq = 168.41 ± 38.80 ml/ min/1.73 m2, Ccr = 146.27 ± 30.49 ml/min / 1.73 m2, p < 0.001), MDRDeq underestimated renal function (Ccr = 146.27 ± 30.49 ml/min / 1.73 m2, MDRDeq = 129.15 ± 29.28 ml/min / 1.73m2, p < 0.001). Conclusions: Our results demonstrated that CGeq overestimated, MDRDeq underestimated significantly kidney function during gestation in healthy women and cannot be recommended to assess renal function in obstetric practice. Ccr remains a useful clinical tool in pregnant women until the development of a specific equation that considers the several important maternal renal physiological alterations and provides the measure of GFR the most unbiased and precise as possible.
文摘目的:以99mTc-DPTA血浆清除率为标准,对24h内生肌酐清除率(Ccr)、Cockcroft-Gault(CG)方程和简化MDRD(modification of diet in renal disease)方程进行比较,评价三种方程在慢性肾脏疾病(CKD)患者中的应用。方法:选择139例各种慢性肾脏疾病患者,将Ccr、CG方程和简化MDRM方程估算的肾小球滤过率(GFR)用体表面积(BSA)标准化,与BSA标准化的99mTc-DTPA测得的GFR(99mTc-GFR)在不同CKD分期进行比较。结果:CKD第一至第五期:Ccr与99mTc-GFR相关系数r分别为:0.79、0.71、0.64、0.59、0.52;Ccr在ROC曲线下面积平均为0.79。CG-GFR与99mTc-GFR相关系数r分别为:0.85、0.78、0.72、0.67、0.61;CG-GFR在ROC曲线下面积平均为0.83。MDRD-GFR与99mTc-GFR相关系数r分别为:0.83、0.76、0.69、0.65、0.59;MDRD-GFR在ROC曲线下面积平均为0.82。在CKD不同分期三种方程的GFR估算值与99mTc-GFR差异均有显著意义(P均<0.001)。结论:三种方程的GFR估算值与99mTc-GFR均有较好的相关性和ROC曲线下面积,以CG方程最好,其次为简化MDRD方程,Ccr最低,但三种方程估算值与99mTc-GFR测定值差异均有显著意义。上述方程直接应用于我国CKD患者时,应对其进行适当修正。
