From the *Department of Nuclear Medicine, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China; †Department of Nuclear Medicine, Chinese PLA General Hospital, Beijing, People's Republic of China; and ‡Department of Nephrology, Chinese PLA General Hospital, Beijing, People's Republic of China.
Clin Nucl Med. 2014 Aug;39(8):690-3. doi: 10.1097/RLU.0000000000000501.
To compare glomerular filtration rate (GFR) among individuals, GFR is usually scaled to body surface area (BSA) based on the ratio method, which has been debated for its accuracy in recent years. Reference to the BSA as a normalization standard is the most common method currently in use but has limitations. This study was designed to a better variable to scale GFR.
We measured 99mTc- diethylene triamine pentaacetic acid plasma clearance (uncorrected GFR, uGFR) for 322 healthy adults who were enrolled according to the SENIEUR protocol. The individuals were randomly grouped into A and B for regressing and validating the optimal variable, respectively. Nonlinear regression was performed against uGFR, and the selected independent variables were body weight, height, age, and sex.
Among several tested models, the regression coefficients of weight-age formula (W-A) were in narrower 95% confidence interval (CI). The coefficient of determination of the regression line between W-A and uGFR, as an indicator to explain the percentage of variations of GFR, was higher than that of other variables in both groups. The coefficient of determination of the regression line between W-A and uGFR was 0.571, which was higher than that of BSA (0.203) or TBW (0.241).
The index variable, based on both body weight and age, has a better statistical relationship to uGFR and is a better variable to scale GFR in adults.
为了比较个体之间的肾小球滤过率（GFR），通常根据比率法将 GFR 按体表面积（BSA）进行标化，近年来，这种方法的准确性一直存在争议。参考 BSA 作为标准化标准是目前最常用的方法，但存在局限性。本研究旨在寻找更好的 GFR 标化变量。
我们根据 SENIEUR 方案，对 322 名健康成年人进行了 99mTc-二乙三胺五乙酸血浆清除率（未校正 GFR，uGFR）测量。将个体随机分为 A 组和 B 组，分别用于回归和验证最佳变量。对 uGFR 进行非线性回归，选择的独立变量为体重、身高、年龄和性别。
在几种测试模型中，体重-年龄公式（W-A）的回归系数在更窄的 95%置信区间（CI）内。W-A 与 uGFR 之间回归直线的确定系数，作为解释 GFR 变化百分比的指标，在两组中均高于其他变量。W-A 与 uGFR 之间回归直线的确定系数为 0.571，高于 BSA（0.203）或 TBW（0.241）。
基于体重和年龄的指数变量与 uGFR 具有更好的统计学关系，是成人 GFR 标化的更好变量。
