Poggio Emilio D, Rule Andrew D, Tanchanco Roberto, Arrigain Susana, Butler Robert S, Srinivas Titte, Stephany Brian R, Meyer Kathryn H, Nurko Saul, Fatica Richard A, Shoskes Daniel A, Krishnamurthi Venkatesh, Goldfarb David A, Gill Inderbir, Schreiber Martin J
Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland,Ohio 44195, USA.
Kidney Int. 2009 May;75(10):1079-87. doi: 10.1038/ki.2009.11. Epub 2009 Feb 11.
Due to the shortage of organs, living donor acceptance criteria are becoming less stringent. An accurate determination of the glomerular filtration rate (GFR) is critical in the evaluation of living kidney donors and a value exceeding 80 ml/min per 1.73 m(2) is usually considered suitable. To improve strategies for kidney donor screening, an understanding of factors that affect GFR is needed. Here we studied the relationships between donor GFR measured by (125)I-iothalamate clearances (mGFR) and age, gender, race, and decade of care in living kidney donors evaluated at the Cleveland Clinic from 1972 to 2005. We report the normal reference ranges for 1057 prospective donors (56% female, 11% African American). Females had slightly higher mGFR than males after adjustment for body surface area, but there were no differences due to race. The lower limit of normal for donors (5th percentile) was less than 80 ml/min per 1.73 m(2) for females over age 45 and for males over age 40. We found a significant doubling in the rate of GFR decline in donors over age 45 as compared to younger donors. The age of the donors and body mass index increased over time, but their mGFR, adjusted for body surface area, significantly declined by 1.49+/-0.61 ml/min per 1.73 m(2) per decade of testing. Our study shows that age and gender are important factors determining normal GFR in living kidney donors.
由于器官短缺，活体供体的接受标准正变得不那么严格。准确测定肾小球滤过率（GFR）对于活体肾供体的评估至关重要，通常认为每1.73平方米超过80毫升/分钟的值是合适的。为了改进肾供体筛查策略，需要了解影响GFR的因素。在此，我们研究了1972年至2005年在克利夫兰诊所接受评估的活体肾供体中，通过（125）I-碘他拉酸盐清除率测量的供体GFR（mGFR）与年龄、性别、种族和护理年代之间的关系。我们报告了1057名潜在供体（56%为女性，11%为非裔美国人）的正常参考范围。在调整体表面积后，女性的mGFR略高于男性，但种族之间没有差异。45岁以上的女性和40岁以上的男性供体的正常下限（第5百分位数）低于每1.73平方米80毫升/分钟。我们发现，与年轻供体相比，45岁以上供体的GFR下降速率显著增加了一倍。供体的年龄和体重指数随时间增加，但经体表面积调整后的mGFR每十年显著下降1.49±0.61毫升/分钟每1.73平方米。我们的研究表明，年龄和性别是决定活体肾供体正常GFR的重要因素。
