Brandt John R, Wong Craig S, Hanrahan Jeffery D, Qualls Clifford, McAfee Nancy, Watkins Sandra L
UNMSOM Department of Pediatrics, Division of Nephrology, University of New Mexico, Albuquerque, NM 87131, USA.
Pediatr Nephrol. 2006 Dec;21(12):1865-72. doi: 10.1007/s00467-006-0254-8. Epub 2006 Sep 30.
Normal values of glomerular filtration rate (GFR) in children are often expressed in a value adjusted to adult ideal body surface area. These values work well for many clinical situations, but in infants and children, especially those with atypical body mass, they may not accurately reflect renal function. Most body composition values in children are expressed in developmentally appropriate ranges. Absolute GFR (ml/min) also changes during childhood increasing rapidly in infancy and then gradually with age and body size. Previously, we developed a bedside equation for estimating GFR (ml/min) in children that accounted for changes with age and body size, and which correlated well with steady-state cold iothalamate GFR (ml/min) measurements: GFR (ml/min) = k(*)sqrt[(age(months) + 6)*wt (kg)/serum Cr (mg/dl)], where k=0.95 for females and 1.05 for males. In the present study GFR (ml/min) measured by iothalamate infusion was compared by correlation analysis with estimates calculated from the above equation in 566 children. This equation provides clinicians with a simple bedside method to estimate absolute GFR (ml/min).
儿童肾小球滤过率(GFR)的正常数值通常以根据成人理想体表面积调整后的数值来表示。这些数值在许多临床情况下适用,但对于婴儿和儿童,尤其是那些体型不典型的儿童,它们可能无法准确反映肾功能。儿童的大多数身体成分数值是以适合其发育阶段的范围来表示的。绝对GFR(毫升/分钟)在儿童期也会发生变化,在婴儿期迅速增加,然后随着年龄和体型逐渐变化。此前,我们开发了一个用于估算儿童GFR(毫升/分钟)的床边公式,该公式考虑了年龄和体型的变化,并且与稳态冷异泛影葡胺GFR(毫升/分钟)测量值相关性良好:GFR(毫升/分钟)=k×√[(月龄+6)×体重(千克)/血清肌酐(毫克/分升)],其中女性k = 0.95,男性k = 1.05。在本研究中,通过相关分析比较了566名儿童中通过异泛影葡胺输注测量的GFR(毫升/分钟)与根据上述公式计算的估算值。该公式为临床医生提供了一种简单的床边方法来估算绝对GFR(毫升/分钟)。