Department of Nephrology, Roskilde University Hospital, University of Copenhagen, Roskilde, Denmark.
J Clin Lab Anal. 2014 Mar;28(2):83-90. doi: 10.1002/jcla.21648. Epub 2013 Dec 27.
Kidney function is mostly expressed in terms of glomerular filtration rate (GFR). A common feature is the expression as ml/min per 1.73 m(2) , which represents the adjustment of the individual kidney function to a standard body surface area (BSA) to allow comparison between individuals. We investigated the impact of indexing GFR to BSA in cancer patients, as this BSA indexation might affect the reported individual kidney function.
Cross-sectional study of 895 adults who had their kidney function measured with (51) chrome ethylene diamine tetraacetic acid. Mean values of BSA-indexed GFR vs. mean absolute GFR were analyzed with a t-test for paired data. Bland-Altman plot was used to analyze agreement between the indexed and absolute GFR values.
BSA-GFR in patients with a BSA <1.60 m(2) overestimated GFR with a bias of 10.08 ml/min (11.46%) and underestimated GFR in those with a BSA >2 m(2) with a bias up to -20.76 ml/min (-23.59%). BSA is not a good normalization index (NI) in patients with extreme body sizes. Therefore, until a better NI is found, we recommend clinicians to use the absolute GFR to calculate individual drug chemotherapy dosage as well as express individual kidney function.
肾功能主要以肾小球滤过率（GFR）表示。一个常见的特征是以 ml/min/1.73m² 的形式表达，这代表了个体肾功能对标准体表面积（BSA）的调整，以允许个体之间进行比较。我们研究了在癌症患者中对 GFR 进行 BSA 指数化的影响，因为这种 BSA 指数化可能会影响报告的个体肾功能。
对 895 名成年人进行了横断面研究，他们使用（51）铬乙二胺四乙酸测量了肾功能。使用配对数据的 t 检验分析了 BSA 指数化 GFR 的平均值与绝对 GFR 的平均值。Bland-Altman 图用于分析指数化和绝对 GFR 值之间的一致性。
BSA<1.60 m² 的患者的 BSA-GFR 高估了 GFR，偏差为 10.08 ml/min（11.46%），而 BSA>2 m² 的患者的 BSA-GFR 低估了 GFR，偏差高达-20.76 ml/min（-23.59%）。BSA 不是体型极端患者的良好归一化指数（NI）。因此，在找到更好的 NI 之前，我们建议临床医生使用绝对 GFR 来计算个体药物化疗剂量，并表达个体肾功能。
