Abstract:

Ｏｂｊｅｃｔｉｖｅ：To investigate the clinical value and application of 3  glomerular filtration rate estimation equations（CKDEPI2009SCr、CKDEPI2012Cys C、CKDEPI2012SCrCys C）in elderly patients with diabetic nephropathy（DN）.
Ｍｅｔｈｏｄｏｌｏｇｙ：One hundred and twentyfour patients with diabetic nephropathy who were hospitalized with GFR being measured by dynamic renal imaging with 99mTcDTPA from January 2013 to May 2016 were enrolled in this study. GFR was measured by 99mTcDTPA renal dynamic imaging method as GFR reference standard（rGFR）, the GFR values estimated by the 3 CKDEPI equations were compared, and the diagnostic accuracy of each prediction equation was evaluated by ROC curve.
Ｒｅｓｕｌｔｓ：rGFR levels in 124 DN patients were（6573±2362）ml/(min·173m2). Estimation of glomerular filtration rate（eGFR）by 3 CKDEPI equations were significantly correlated with rGFR（r=0742，P=0000；r=0713，P=0000；r=0816，P=0000）. The results of BlandAltman diagram showed that the consistency of the 3 evaluation equations was not good, the deviation degree of eGFR and rGFR from the CKDEPI2012SCrCys C equation was the least. Linear regression results showed that the CKDEPI2012SCrCys C equation estimated GFR and slope of X axis was smaller than other equations, and its estimated GFR of 30% accuracy>70%. In the different stages of chronic kidney disease（CKD）, the CKDEPI2012SCrCys C equation estimated GFR of 15% accuracy, 30% accuracy and 50% accuracy were higher, its estimated of GFR and rGFR deviation and deviation from the measured value were small. According to the result of the ROC curve, the evaluation equation of AUC and 95%CI respectively 0882（0806～0952）、0876（0796～0934）、0918（0843～0986）, which CKDEPI2012SCrCys C equation for sensitivity and specificity were higher.
Ｃｏｎｃｌｕｓｉｏｎ：The accuracy of theCKDEPI2012SCrCys C equation for estimate GFR is better than that of the CKDEPI2009SCr equation and CKDEPI2012Cys C equation in elderly DN patients, but the consistency limit exceeds the acceptable professional value.