Department of Intensive Care, Austin Hospital, Heidelberg, Victoria, Australia.
Ren Fail. 2010 Jan;32(3):349-55. doi: 10.3109/08860221003611695.
During acute kidney injury (AKI), lowered glomerular filtration rate (GFR) is believed to be consequent to reduced renal plasma flow (RPF). We aimed to systematically evaluate the evidence for such an association. Using specific search terms, we systematically interrogated the Pub Med electronic reference database for studies of human AKI where renal plasma or blood flow and GFR were measured; older articles were then identified by screening bibliographies of retrieved reports. We identified 22 articles describing 250 patients (203 native kidney, 47 in renal allograft). Of these studies, 8 articles (110 patients) estimated effective renal plasma flow (ERPF) by clearance techniques and 14 articles (140 patients) estimated true renal plasma flow (TRPF). Mean RPF was 272 mL/min (95% CI 213-331) and GFR 13.9 mL/min (9.9-17.9). Mean TRPF was significantly greater than mean ERPF (344 vs. 180, p=0.004) despite lower mean GFR (8.8 vs. 20.4, p=0.002). There was no significant association between RPF and GFR between studies. Eleven studies presented individual patient data (76 patients: 49 TRPF, 27 ERPF); here, individual patient ERPF was associated with GFR (r2=0.52), but TRPF was not. During AKI in man, there is only a limited association between ERPF and GFR, and no detectable association between TRPF and GFR.
在急性肾损伤 (AKI) 期间，肾小球滤过率 (GFR) 的降低被认为是由于肾血浆流量 (RPF) 的减少所致。我们旨在系统地评估这种关联的证据。使用特定的搜索词，我们系统地查询了 Pub Med 电子参考数据库中有关人类 AKI 的研究，其中测量了肾血浆或血流和 GFR；然后通过筛选检索报告的参考文献来识别较旧的文章。我们确定了 22 篇描述 250 例患者（203 例为原生肾脏，47 例为肾移植）的文章。在这些研究中，有 8 篇文章（110 例患者）通过清除技术估计有效肾血浆流量（ERPF），14 篇文章（140 例患者）估计真实肾血浆流量（TRPF）。平均 RPF 为 272mL/min（95%CI 213-331），GFR 为 13.9mL/min（9.9-17.9）。尽管平均 GFR 较低（8.8 vs. 20.4，p=0.002），但平均 TRPF 明显大于平均 ERPF（344 vs. 180，p=0.004）。在研究之间，RPF 和 GFR 之间没有显著的相关性。11 项研究提供了个体患者数据（76 例患者：49 例 TRPF，27 例 ERPF）；在这里，个体患者的 ERPF 与 GFR 相关（r2=0.52），但 TRPF 则不然。在人类 AKI 期间，ERPF 与 GFR 之间仅有有限的相关性，而 TRPF 与 GFR 之间则没有检测到相关性。
