Otani Tomoko, Kase Yasuko, Kunitomo Kazufumi, Shimooka Kazumi, Naoe Mitsugu, Yamamoto Hiroko, Kawazoe Kazuyoshi, Sato Youichi, Yamauchi Aiko
Department of Pharmaceutical Information Science, Institute of Biomedical Sciences, Tokushima University Graduate School.
Department of Pharmacy, Naruto Yamakami Hospital.
J Med Invest. 2018;65(3.4):195-202. doi: 10.2152/jmi.65.195.
In recumbent elderly patients, creatinine clearance (eCCr) estimated by the Cockcroft-Gault (CG) equation may not necessarily reflect renal function. We aimed to develop a novel formula to revise the CG equation using anthropometric measurements in bedridden elderly patients and evaluate its clinical utility. The subjects included 77 bedridden Japanese patients aged ≦ 65, hospitalized at Naruto Yamakami Hospital. The actual CCr (mCCr) value was measured using the 24-hour urine collection method. Anthropometric data, such as skeletal muscle mass, body fat mass (BFM), and triceps skinfold thickness (TSF), were collected. We established a novel formula to estimate CCr or CCr by correcting the eCCr value with BFM or TSF. The stage of classification of renal dysfunctions in patients with eGFR or eGFR was equivalent to the GFR based on the mCCr. Notably, the novel equation for eCCr based on TSF (eCCr), dubbed the "Naruto" formula, can be useful to evaluate renal function in bedridden elderly patients without expensive equipment or additional costs. In this study, mCCr was considered to be the true renal function of the patient, but whether and to what extent mCCr correlates with inulin clearance is unknown. J. Med. Invest. 65:195-202, August, 2018.
在卧床老年患者中，通过Cockcroft-Gault（CG）方程估算的肌酐清除率（eCCr）不一定能反映肾功能。我们旨在开发一种新公式，利用卧床老年患者的人体测量数据对CG方程进行修正，并评估其临床实用性。研究对象包括77名年龄≤65岁、入住鸣门山川医院的卧床日本患者。采用24小时尿液收集法测量实际肌酐清除率（mCCr）值。收集骨骼肌质量、体脂质量（BFM）和肱三头肌皮褶厚度（TSF）等人体测量数据。我们通过用BFM或TSF校正eCCr值，建立了一种估算CCr或CCr的新公式。根据mCCr，eGFR或eGFR患者的肾功能不全分级阶段与肾小球滤过率（GFR）相当。值得注意的是，基于TSF的eCCr新方程（eCCr），即所谓的“鸣门”公式，在不使用昂贵设备或不产生额外费用的情况下，可用于评估卧床老年患者的肾功能。在本研究中，mCCr被视为患者的真实肾功能，但mCCr与菊粉清除率是否相关以及相关程度尚不清楚。《医学调查杂志》65:195 - 202，2018年8月。
