BACKGROUND:It is unclear which renal function equation, employing an isotope dilution mass spectrometry (IDMS)-aligned creatinine assay, best predicts gentamicin clearance.
METHODS:The performances of the Cockcroft-Gault, Modification of Diet in Renal Disease (MDRD) Study and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations for predicting gentamicin clearances were assessed retrospectively in 240 patients treated with gentamicin during 2011-2012, when the local creatinine assay was IDMS-aligned. Comparisons were based on the percentage within 30% of gentamicin clearance (P 30) and the root-mean-square error (RMSE) of each equation. Gentamicin clearance was calculated from plasma concentrations using a one-compartment model.
RESULTS:The Cockcroft-Gault equation and the CKD-EPI equation corrected for individual body surface area (BSA) were associated with the highest P 30 (69% and 67%, respectively) and lowest RMSE (39 and 36 mL/min, respectively) in the 240 patients. Correction for individual BSA improved the performances of the MDRD Study and CKD-EPI equations in patients with body mass indices <18.5 or ≥30 kg/m(2). The equations systematically underestimated gentamicin clearance as gentamicin clearance increased, with performance being inferior with gentamicin clearance ≥90 versus <90 mL/min.
CONCLUSIONS:The CKD-EPI equation corrected for individual BSA, and the Cockcroft-Gault equation, provided the best estimates of gentamicin clearance. The CKD-EPI and MDRD Study equations should be corrected for individual BSA at the extremes of body size, if used for guiding gentamicin therapy. The performances of the equations were inferior in patients with higher values of gentamicin clearance.
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【The performances of the Cockcroft-Gault, modification of diet in renal disease study and chronic kidney disease epidemiology collaboration equations in predicting gentamicin clearance.].
【在预测庆大霉素清除率方面，Cockcroft-Gault，肾脏疾病研究中饮食的调整以及慢性肾脏病流行病学协作方程的性能。】
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DOI：10.1177/0004563213492320文章类型：杂志文章
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背景：目前尚不清楚采用同位素稀释质谱（IDMS）校正的肌酐测定法哪个肾功能方程能最好地预测庆大霉素的清除率。
方法：回顾性分析了2011-2012年间240例接受庆大霉素治疗的患者的Cockcroft-Gault方法，肾脏疾病饮食调整（MDRD）和慢性肾脏病流行病学协作（CKD-EPI）方程预测庆大霉素清除率的性能，当局部肌酐测定与IDMS一致时。比较的依据是庆大霉素清除率（P 30）在30％以内的百分比以及每个方程式的均方根误差（RMSE）。使用一室模型由血浆浓度计算庆大霉素清除率。
结果：针对个体体表面积（BSA）校正的Cockcroft-Gault方程和CKD-EPI方程与最高的P 30（分别为69％和67％）和最低的RMSE（分别为39和36 / mL / min）相关联）在240位患者中。体重指数<18.5或≥30kg / m（2）的患者，对个别BSA进行校正可改善MDRD研究和CKD-EPI方程的性能。随着庆大霉素清除率的增加，方程式系统地低估了庆大霉素的清除率，而庆大霉素清除率≥90相对于<90 / mL / min，其性能较差。
结论：针对个别BSA校正的CKD-EPI方程和Cockcroft-Gault方程提供了庆大霉素清除率的最佳估计。如果用于指导庆大霉素治疗，则应针对个体BSA在极端情况下校正CKD-EPI和MDRD研究方程式。在庆大霉素清除率较高的患者中，该方程的性能较差。
方法：回顾性分析了2011-2012年间240例接受庆大霉素治疗的患者的Cockcroft-Gault方法，肾脏疾病饮食调整（MDRD）和慢性肾脏病流行病学协作（CKD-EPI）方程预测庆大霉素清除率的性能，当局部肌酐测定与IDMS一致时。比较的依据是庆大霉素清除率（P 30）在30％以内的百分比以及每个方程式的均方根误差（RMSE）。使用一室模型由血浆浓度计算庆大霉素清除率。
结果：针对个体体表面积（BSA）校正的Cockcroft-Gault方程和CKD-EPI方程与最高的P 30（分别为69％和67％）和最低的RMSE（分别为39和36 / mL / min）相关联）在240位患者中。体重指数<18.5或≥30kg / m（2）的患者，对个别BSA进行校正可改善MDRD研究和CKD-EPI方程的性能。随着庆大霉素清除率的增加，方程式系统地低估了庆大霉素的清除率，而庆大霉素清除率≥90相对于<90 / mL / min，其性能较差。
结论：针对个别BSA校正的CKD-EPI方程和Cockcroft-Gault方程提供了庆大霉素清除率的最佳估计。如果用于指导庆大霉素治疗，则应针对个体BSA在极端情况下校正CKD-EPI和MDRD研究方程式。在庆大霉素清除率较高的患者中，该方程的性能较差。
