tailieunhanh - Báo cáo y học: "Does eGFR improve the diagnostic capability of S-Creatinine concentration results? A retrospective population based study"

Tuyển tập các báo cáo nghiên cứu khoa học ngành y học tạp chí Medical Sciences dành cho các bạn sinh viên ngành y tham khảo đề tài: Does eGFR improve the diagnostic capability of S-Creatinine concentration results? A retrospective population based study. | Int. J. Med. Sci. 2008 5 9 Research Paper International Journal of Medical Sciences ISSN 1449-1907 2008 5 1 9-17 Ivyspring International Publisher. All rights reserved Does eGFR improve the diagnostic capability of S-Creatinine concentration results A retrospective population based study Anders Kallner 1 Peter A Ayling 2 Zahra Khatami 2 1. Department of Clinical Chemistry Karolinska University Hospital SE 17176 Stockholm Sweden 2. Department of Biochemistry Queen s Hospital Romford Essex RM70AG UK Correspondence to Anders Kallner Associate Professor MD PhD Phone 46 8 5177 4943 Fax 46 8 5177 2899 e-mail Received Accepted Published The use of MDRD-eGFR to diagnose Chronic Kidney Disease CKD is based on the assumption that the algorithm will minimize the influence of age gender and ethnicity that is observed in S-Creatinine concentration and thus allow a single cut-off at which further diagnostic and therapeutic actions should be considered. This hypothesis is tested in a retrospective analysis of outpatients N 93 404 and hospitalised N 35 572 patients in UK and Sweden respectively. An algorithm based on the same model as the MDRD-eGFR algorithm was derived from simultaneously measured S-Creatinine concentrations and lohexol GFR in a subsetof 565 patients. The combined uncertainty of using this algorithm was estimated to about 15 which is about three times that of the S-Creatinine concentration results. The diagnostic performance of S-Creatinine concentration was evaluated using the lohexol clearance as the reference procedure. It was shown that the diagnostic capacity of MDRD-eGFR as it stands has no added value compared to S-Creatinine. The gender and age differences of the S-Creatinine concentrations in the dataset persist after applying the MDRD-eGFR algorithm. Thus a general use of the MDRD-eGFR does not seem justified. Furthermore the claim that the eGFR is adjusted for body area is misleading