Division of Nephrology, Department of Medicine, Queen's University, Kingston, Canada K7L 2V6.
Transplant Rev (Orlando). 2010 Jan;24(1):18-27. doi: 10.1016/j.trre.2009.10.001.
Evaluation of kidney function is crucial in the care of kidney transplant recipients and in the design and interpretation of clinical trials in transplantation. Kidney function is most commonly assessed in both instances using serum creatinine concentration or an estimate of glomerular filtration rate (GFR) based on serum creatinine. These are inexpensive, widely available, and easily administered. Both have significant drawbacks, notably with respect to their inability to accurately identify changes in GFR. Novel markers of GFR such as cystatin C and beta-trace protein show promise as accurate and sensitive markers of GFR but have not yet been adequately evaluated in kidney transplantation. In addition, they are relatively expensive compared to creatinine and their assays are not available in most clinical laboratories. Glomerular filtration rate measurement using a variety of different available tracers and techniques is infrequently used in either clinical care or research protocols because of its cost and cumbersomeness. This review will discuss the merits and pitfalls of the various tools available to evaluate GFR in kidney transplantation.
评估肾功能对于肾移植受者的护理以及移植相关临床试验的设计和解读至关重要。在这两种情况下，通常使用血清肌酐浓度或基于血清肌酐的肾小球滤过率（GFR）估计值来评估肾功能。这些方法价格低廉、广泛可用且易于管理。但它们都存在明显的缺陷，尤其是无法准确识别 GFR 的变化。GFR 的新型标志物，如胱抑素 C 和β-痕迹蛋白，作为 GFR 的准确和敏感标志物具有很大的应用前景，但在肾移植中尚未得到充分评估。此外，与肌酐相比，这些标志物相对昂贵，并且它们的检测在大多数临床实验室中都不可用。由于其成本和繁琐性，使用各种不同的示踪剂和技术来测量肾小球滤过率在临床护理或研究方案中很少使用。这篇综述将讨论评估肾移植中 GFR 的各种工具的优缺点。
