Donadio C, Abdelkawy H, Grassi G
Department of Internal Medicine, Division of Nephrology, University of Pisa, Azienda Ospedaliero-Universitaria, Pisa, Italy.
Transplant Proc. 2010 May;42(4):1035-9. doi: 10.1016/j.transproceed.2010.03.039.
In potential living kidney donors, glomerular filtration rate (GFR) is often evaluated from the creatinine clearance (Ccr) or is predicted using formulas based on serum creatinine (SCr) or cystatin C (SCys) concentration. Ultrasonography is used to evaluate renal structure and dimensions. The objective of the present study was to evaluate the possibility of estimation of GFR from echographic renal dimensions in 66 potential live kidney donors (46 women and 20 men; age range, 25-73 years). The GFR was measured as the renal clearance of technetium 99m diethylenetriamine pentaacetic acid. The GFR was also estimated from the SCr concentration using the Cockcroft-Gault (CG-Ccr) and Modification of Diet in Renal Disease (MDRD-GFR) formulas and from SCys (Cys-GFR). Renal diameters were measured using conventional gray-scale renal ultrasound to estimate total and parenchymal renal volume using ellipsoid formulas. The GFR was predicted from renal dimensions on the basis of their relationship to measured GFR. Estimates of GFR obtained using renal volume more close correlated with measured GFR than did CG-Ccr, MDRD-GFR, or Cys-GFR. The mean difference from measured GFR was null. The GFR estimated from renal volume demonstrated better agreement with measured GFR and a lower prediction error vs values from the other prediction formulas (18.3 vs 22-34 mL/min). The GFR values predicted from renal volume were quite accurate as indicators of GFR less than 80 mL/min. In potential living kidney donors, sonographic renal volume provided more accurate estimates of GFR, with lower prediction error, compared with formulas based on SCr or SCys.
在潜在的活体肾供体中,肾小球滤过率(GFR)通常通过肌酐清除率(Ccr)进行评估,或使用基于血清肌酐(SCr)或胱抑素C(SCys)浓度的公式进行预测。超声检查用于评估肾脏结构和尺寸。本研究的目的是评估在66名潜在的活体肾供体(46名女性和20名男性;年龄范围为25 - 73岁)中,根据超声测量的肾脏尺寸估计GFR的可能性。GFR通过锝99m二乙三胺五乙酸的肾脏清除率来测量。GFR还使用Cockcroft - Gault(CG - Ccr)公式和肾脏疾病饮食改良(MDRD - GFR)公式根据SCr浓度进行估计,并根据SCys(Cys - GFR)进行估计。使用传统灰阶肾脏超声测量肾脏直径,并用椭圆公式估计肾脏总体积和实质体积。根据肾脏尺寸与测量的GFR之间的关系预测GFR。与CG - Ccr、MDRD - GFR或Cys - GFR相比,使用肾脏体积获得的GFR估计值与测量的GFR相关性更强。与测量的GFR的平均差异为零。与其他预测公式的值相比,根据肾脏体积估计的GFR与测量的GFR一致性更好,预测误差更低(分别为18.3与22 - 34 mL/min)。当GFR小于80 mL/min时,根据肾脏体积预测的GFR值作为GFR指标相当准确。在潜在的活体肾供体中,与基于SCr或SCys的公式相比,超声测量的肾脏体积能提供更准确的GFR估计值,预测误差更低。