Lacour B
INSERM U90, Hôpital Necker, Paris, France.
Nephrologie. 1992;13(2):73-81.
Serum creatinine remains the most widely used measure of renal function in clinical practice and in clinical trials. However, the serum concentration reflects not only renal excretion, which is composed of filtration and tubular secretion, but also the generation, intake, and metabolism of creatinine. Thus, serum creatinine does not provide an adequate estimate of glomerular filtration rate (GFR). Creatinine clearance is also an inaccurate and imprecise measure of GFR in clinical practice. The questions concerning the abnormality or the change of glomerular function can be answered with greater accuracy and precision by serum creatinine if the factors affecting its concentration are taken into account. The slope of the decline in reciprocal serum creatinine versus time does not accurately reflect changes in creatinine clearance and does not allow an accurate assessment of the rate of progression of renal disease. It can even be hazardous to use such value to observe the efficacy of treatments for progressive renal diseases.
血清肌酐仍然是临床实践和临床试验中最广泛使用的肾功能指标。然而，血清浓度不仅反映由滤过和肾小管分泌组成的肾脏排泄，还反映肌酐的生成、摄入和代谢。因此，血清肌酐并不能充分估计肾小球滤过率（GFR）。在临床实践中，肌酐清除率也是对GFR不准确且不精确的测量指标。如果考虑到影响血清肌酐浓度的因素，关于肾小球功能异常或变化的问题可以通过血清肌酐更准确和精确地得到解答。血清肌酐倒数与时间下降的斜率不能准确反映肌酐清除率的变化，也无法准确评估肾脏疾病的进展速度。使用该值来观察进行性肾脏疾病的治疗效果甚至可能是有害的。
