使用西咪替丁的肾胰联合移植患者中通过公式预测肾小球滤过率
Prediction of the glomerular filtration rate using equations in kidney-pancreas transplant patients receiving cimetidine.
作者信息
Schiff Jeffrey, Paraskevas Steven, Keith Douglas, Tchervenkov Jean, Metrakos Peter, Cantarovich Marcelo
机构信息
Department of Medicine, Royal Victoria Hospital, McGill University Health Centre, Montréal, Québec, Canada.
出版信息
Transplantation. 2006 Feb 15;81(3):469-72. doi: 10.1097/01.tp.0000181112.02227.fc.
BACKGROUND
Current estimates of renal function in kidney transplant patients are frequently inaccurate compared to radionuclide GFR (rGFR) measurement. Cimetidine inhibits tubular secretion of creatinine and improves the accuracy of formulas to estimate GFR.
METHODS
We studied the effect of a cimetidine-aided (800 mg tid for 24 hr) serum creatinine on the correlation of creatinine clearance and three prediction formulas (Cockroft-Gault, Levey, and Nankivell) compared to rGFR in 15 kidney-pancreas transplant patients. Results were adjusted for body surface area.
RESULTS
Correlations with rGFR using cimetidine-aided creatinine were: Cockroft-Gault, r=0.710; Levey, r=0.752; Nankivell, r=0.676; creatinine clearance, r=0.643. By Bland and Altman analysis, agreement with rGFR was best with the Nankivell and Cockroft-Gault equations and worst with creatinine clearance. Cimetidine ($0.48 Canadian) costs substantially less than the rGFR test ($66.00 Canadian).
CONCLUSION
Using cimetidine, prediction equations give a stronger correlation with GFR than creatinine clearance.
背景
与放射性核素肾小球滤过率（rGFR）测量相比，目前对肾移植患者肾功能的估计常常不准确。西咪替丁可抑制肌酐的肾小管分泌，并提高估算肾小球滤过率公式的准确性。
方法
我们研究了西咪替丁辅助（800毫克，每日三次，共24小时）血清肌酐对15例肾胰联合移植患者肌酐清除率与三种预测公式（Cockroft-Gault公式、Levey公式和Nankivell公式）与rGFR之间相关性的影响。结果根据体表面积进行了校正。
结果
使用西咪替丁辅助肌酐与rGFR的相关性为：Cockroft-Gault公式，r = 0.710；Levey公式，r = 0.752；Nankivell公式，r = 0.676；肌酐清除率，r = 0.643。通过Bland和Altman分析，Nankivell公式和Cockroft-Gault公式与rGFR的一致性最好，而肌酐清除率与rGFR的一致性最差。西咪替丁（0.48加元）的成本远低于rGFR检测（66.00加元）。
结论
使用西咪替丁时，预测公式与肾小球滤过率的相关性比肌酐清除率更强。
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