麦考瑞代写Assignment:肾脏疾病的健康估计GFR

麦考瑞代写Assignment:肾脏疾病的健康估计GFR

麦考瑞代写Assignment:肾脏疾病的健康估计GFR

我们进行了一项横断面70例超过2006一月至2006十二月期间的1年在卡拉奇巴基斯坦一家三级医院肾脏病临床研究。我们研究的目的是找出估算的肾小球滤过率(eGFR)之间的相关性,通过修改饮食肾脏疾病(MDRD)和EGFR的Cockcroft Gault(CG)在慢性肾脏疾病(CKD)方程,看他们是否可以交替使用。

年龄范围为15 – 79岁。男49%例,女51%例。急性肾功能衰竭的患者被排除在外。研究中的所有患者均根据肾脏病预后质量倡议分为五组(KDOQI)慢性肾脏病的分类如下:1组:肾小球滤过率>90;2组:肾小球滤过率90 – 60;3组:肾小球滤过率30 – 59;4组:肾小球滤过率15 – 29和5组:肾小球滤过率<15 ml/min/1.73m2。

简短的四变量MDRD公式的应用,估计肾小球滤过率(毫升/分钟每1.73平方米)用公式:186×[血清肌酐(毫克/分升)] -1.154 X(年龄)-0.203 X(0.742女性)。估计肾小球滤过率使用CG方程毫升/分钟)计算方法如下:(140—年龄)×(体重)/肌酐(毫克/分升)×72×(0.85女)。测量肌酐清除率计算了24小时的尿液收集和使用公式:肌酐排泄(毫克/公斤/天)除以血清肌酐(毫克/升)除以14.4(每毫克/毫升)。数据采用SPSS软件分析。

我们的结论是CG公式与MDRD方程在CKD 4期和高估GFR在阶段1,2,3。这两个公式可以互换使用在阶段4和1。24小时尿肌酐清除率的测量还可以如果病人建议正确可靠。

对于1.73的gualt m2.improves Cockcroft-Gault公式的精度,体表面积的GFR正常化。我们推测,这将改善与MDRD公式的关系。但是我们怀疑,包括方程的体表面积的计算公式并gualt将减少在床侧的有用性。

这是不可能的,MDRD公式将取代Cockcroft gualt公式在临床医疗实践中很快因为对计算机程序的依赖。

麦考瑞代写Assignment:肾脏疾病的健康估计GFR

We conducted a cross section study of 70 patients presented to the nephrology clinic of a tertiary care hospital in Karachi Pakistan over a period of 1 year from January 2006 to December 2006. Purpose of our study was to find out correlation between estimated Glomerular Filtration Rate (eGFR) by Modification of Diet in Renal Disease (MDRD) and eGFR by Cockcroft-Gault (CG) equations in patients with chronic kidney disease (CKD) and to see whether they can be used interchangeably.

Age range was 15 – 79 years. Male were 49% , female were 51% . Patients with acute renal failure were excluded. All the patients in the study were divided into five groups according to the kidney disease outcome quality initiative (KDOQI) classification of chronic kidney disease as follows: Group 1: GFR > 90; Group 2: GFR 90 – 60; Group 3: GFR 30 – 59; Group 4: GFR 15 – 29 and group 5: GFR < 15 ml/ min/1.73m2.

Abbreviated four variable MDRD formula was used .to estimated GFR (ml/min per 1.73 m2) using the equation:186 x [serum creatinine (mg/dl)]-1.154 x (age)-0.203 x (0.742 if female) . Estimated GFR using the CG equation ml/min) was calculated as follows: (140 – age) x (weight in kg)/serum creatinine (mg/dl) x 72 x (0.85 if female). Measured creatinine clearance was calculated by 24 hour urine collection and using the formula: creatinine excretion (mg/kg per day) divided by serum creatinine (mg/dl) divided by 14.4 (min/d per dl/ml). Data was analyzed using SPSS software.

We conclude that CG Formula correlates with MDRD equation best at CKD stages 4 and overestimated GFR at stages 1, 2, 3. The two formulas may be used interchangeably at stage 4 & 1. Measurement of 24 hour urine creatinine clearance may still be reliable if patients are counseled properly.

Normalization of GFR for body surface area of 1.73 m2.improves the accuracy of Cockcroft Gualt formula. We speculate that this in turn will improve its correlation with MDRD formula. However we suspect that complicating the Cockcroft Gualt formula by including the body surface area in equation will decrease its usefulness on bed side.

It is unlikely that MDRD formula will replace Cockcroft Gualt formula in clinical medical practice soon because of its dependency upon a computer program.

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