Pottel Hans, Delanaye Pierre, Weekers Laurent, Selistre Luciano, Goffin Karolien, Gheysens Olivier, Dubourg Laurence
Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium.
Nephrology-Dialysis-Transplantation, University of Liège, CHU Sart Tilman, Liège, Belgium.
Clin Kidney J. 2017 Aug;10(4):545-551. doi: 10.1093/ckj/sfx026. Epub 2017 Apr 28.
Defining mean and reference intervals for glomerular filtration rate (GFR) has been the subject of only a limited number of studies and review articles, with contradicting statements about the mean. Normal measured GFR (mGFR) values of ∼120-130 mL/min/1.73 m have long been the referenced values for young adults but seem to be too high according to recent studies. Reference intervals are difficult to define because of the age decline of GFR, which is also observed in healthy subjects. Little data are available for subjects >70 years of age.
Based on the reference intervals for serum creatinine (SCr) and the recently published full-age spectrum (FAS) equation, we define simple age-dependent equations for the reference limits of GFR. The mGFR of 633 living potential kidney donors was used to validate the new formulae that define the reference interval.
The reference limits for estimated GFR (eGFR), calculated by entering the reference limits for SCr into the FAS equation closely correspond with published reference limits for mGFR. Of the mGFRs of potential living kidney donors, 97.2% lie between the newly defined reference limits for GFR.
SCr reference limits may serve to define age-dependent reference limits for eGFR and mGFR.
肾小球滤过率(GFR)均值和参考区间的定义一直是少数研究和综述文章的主题,关于均值的说法相互矛盾。长期以来,约120 - 130 mL/min/1.73 m²的正常实测GFR(mGFR)值一直是年轻人的参考值,但根据最近的研究,这个值似乎过高。由于GFR会随年龄下降,即使在健康受试者中也会出现这种情况,所以参考区间很难定义。对于70岁以上的受试者,可用数据很少。
基于血清肌酐(SCr)的参考区间和最近发表的全年龄谱(FAS)方程,我们定义了GFR参考限值的简单年龄相关方程。使用633名有潜在捐献肾脏能力的活体供者的mGFR来验证定义参考区间的新公式。
通过将SCr的参考限值代入FAS方程计算得到的估计GFR(eGFR)参考限值与已发表的mGFR参考限值密切对应。在有潜在捐献肾脏能力的活体供者的mGFR中,97.2%落在新定义的GFR参考限值之间。
SCr参考限值可用于定义eGFR和mGFR的年龄相关参考限值。