癌症患者床边肾功能评估与测量的肾小球滤过率（Tc99mDTPA清除率）的比较。

A comparison of bedside renal function estimates and measured glomerular filtration rate (Tc99mDTPA clearance) in cancer patients.

作者信息

Poole S G, Dooley M J, Rischin D

机构信息

Department of Pharmacy, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia.

出版信息

Ann Oncol. 2002 Jun;13(6):949-55. doi: 10.1093/annonc/mdf236.

DOI:10.1093/annonc/mdf236

PMID:12123341

Abstract

BACKGROUND

The aim of this study was to compare measured glomerular filtration rate (GFR) with estimates of GFR derived from the population pharmacokinetic methods of Martin and Wright, and the creatinine clearance (CrCl) estimates of Cockcroft and Gault, and Jelliffe.

PATIENTS AND METHODS

GFR was determined by technetium-99m diethyl triamine penta-acetic acid (Tc99DTPA) clearance in adult cancer patients. Height, actual body weight and serum creatinine were measured, and GFR and CrCl estimates calculated.

RESULTS

One hundred and twenty-two patients were included. The mean measured GFR was 87 ml/min (range 30-174 ml/min). The mean bias (mean percentage error) was 2, 1, -10 and -17%, and the mean precision (mean absolute percentage error) was 18, 19, 21 and 23% for the Wright, Martin, Cockcroft and Gault, and Jelliffe formulas, respectively. The Martin formula significantly underestimates GFR for females (mean bias -10%) and overestimates GFR for males (mean bias 8%) (P <0.001 for bias of males versus females). The Wright and Martin formulas significantly overestimate GFR <50 ml/min (mean bias 39 and 30%; P = 0.03 and 0.05, respectively) and all formulas underestimate GFR >100 ml/min (mean bias -18, -16, -24 and -32% for Wright, Martin, Cockcroft and Gault, and Jelliffe formulas, respectively; P <0.001).

CONCLUSIONS

All the assessed estimates for renal function were found to have significant limitations.

摘要

背景

本研究的目的是比较测量的肾小球滤过率（GFR）与通过Martin和Wright的群体药代动力学方法得出的GFR估计值，以及Cockcroft和Gault以及Jelliffe的肌酐清除率（CrCl）估计值。

患者与方法

通过锝-99m二乙三胺五乙酸（Tc99DTPA）清除率测定成年癌症患者的GFR。测量身高、实际体重和血清肌酐，并计算GFR和CrCl估计值。

结果

纳入122例患者。测量的平均GFR为87 ml/分钟（范围30 - 174 ml/分钟）。Wright、Martin、Cockcroft和Gault以及Jelliffe公式的平均偏差（平均百分比误差）分别为2%、1%、-10%和-17%，平均精密度（平均绝对百分比误差）分别为18%、19%、21%和23%。Martin公式显著低估女性的GFR（平均偏差-10%），高估男性的GFR（平均偏差8%）（男性与女性偏差的P<0.001）。Wright和Martin公式显著高估GFR<50 ml/分钟（平均偏差39%和30%；P分别为0.03和0.05），所有公式均低估GFR>100 ml/分钟（Wright、Martin、Cockcroft和Gault以及Jelliffe公式的平均偏差分别为-18%、-16%、-24%和-32%；P<0.001）。