Florkowski Christopher M, Chew-Harris Janice Sc
Clinical Biochemistry Unit, Canterbury Health Laboratories, Christchurch 8011.
Clin Biochem Rev. 2011 May;32(2):75-9.
The initiative for estimating glomerular filtration rate (GFR) derives from the limitations of interpreting plasma creatinine alone, the cost and complexities of determining a gold standard GFR with either inulin or radionuclides, and the inaccuracies inherent in measuring a 24 h urine creatinine clearance. In August 2005, the Australasian Creatinine Consensus Working Group recommended that an eGFR based on the abbreviated MDRD (Modification of Diet in Renal Disease) formula shall be automatically calculated for every request for creatinine in people over 18 years. Uptake was almost universal, though with appropriate caveats in place regarding potential limitations. Updated recommendations in 2007 recognised uniform standardisation of the plasma creatinine assay. A recent development is the CKD-Epidemiology Collaboration (CKD-EPI) equation which confers less underestimation of GFR in subjects with normal renal function. Cystatin C and its derivative equations may have advantages in some situations.
估算肾小球滤过率（GFR）的倡议源于仅解读血肌酐的局限性、使用菊粉或放射性核素测定金标准GFR的成本和复杂性，以及测量24小时尿肌酐清除率所固有的不准确性。2005年8月，澳大拉西亚肌酐共识工作组建议，对于18岁以上人群的每一项肌酐检测申请，应自动计算基于简化版肾脏病膳食改良（MDRD）公式的估算肾小球滤过率（eGFR）。该建议几乎被普遍采用，不过针对潜在局限性也有适当的注意事项。2007年的更新建议认可了血肌酐检测的统一标准化。最近的一项进展是慢性肾脏病流行病学合作（CKD-EPI）方程，该方程在估算肾功能正常受试者的GFR时低估程度较小。胱抑素C及其衍生方程在某些情况下可能具有优势。
