Analysis of the applicability of different glomerular filtration rate estimation formulas in assessing renal func-tion in critically ill pregnant women

CHEN Chen; LI Guo-fu

doi:10.19538/j.fk2025030117

Abstract：Objective This study intends to initially select a formula more suitable for eGFR assessment in critically ill women in China,In order to quickly and accurately assess the degree of kidney injury,early detection of AKI,to ensure the life safety of critically ill pregnant women and perinatal infants.Methods In this study,The critically ill pregnant women who were hospitalized in the intensive care unit of Shengjing Hospital Affiliated to China Medical University from January 2016 to December 2020 were studied,To diagnose AKI by using the KDIGO criteria,using the Cockroft-Gault formula,the simplified MDRD Formula,the FAS formula and the BIS-1 formula were used to draw ROC curves to evalu-ate the efficacy of each formula in diagnose AKI.According to age,gestational history and gestational age,to evaluate the diagnostic efficacy of each formula within the subgroups.Results Among the overall critically ill mothers,the simpli-fied MDRD formula had the highest sensitivity of 65.48％.By age,gestational history and gestational age,in the subgroup aged＜35 years,the highest AUC value was 0.669 of the FAS formula.In the subgroup of age 35 years,the highest AUC value was 0.872 for the C-G formula.In primigravous women,BIS-1 formula had the highest AUC value reaching 0.692 and in multiparous women FAS formula had the highest AUC value reaching 0.738.In the subgroup of＜37 weeks,the higher AUC value was 0.736 of the FAS formula and 0.734 of the simplified MDRD formula,while the highest sensitivity was 63.49％of the simplified MDRD formula and BIS-1 formula;in the subgroup of 37 weeks of gestation,the AUC value of each formula decreased,in which the C-G formula and BIS-1 formula were relatively high.Conclusions This study shows that simplified MDRD formulas with high sensitivity are recommended in the total population.In the subgroup with age＜35 years,the FAS formula is recommended,and in those with age 35 years,the C-G formula,the FAS formula,and the simplified MDRD formula are recommended.BIS-1 formula was used in primipara and FAS formula is recommended in multiparous women.The simplified MDRD formula is recommended in the subgroup of＜37 weeks,and in the subgroup with gestational age≥37 weeks,The C-G formula and the BIS-1 formula are recommended.For now,no matter what the formula is,there are certain defects in the process of evaluating kidney function in critically ill mothers.There are few relevant studies on the application of the new formula in this aspect,and local formulas should be formulated according to the situation of Chinese people as much as possible.