Department of Pediatrics, Kingston Health Sciences Centre, Queen's University, 76 Stuart St, Kingston, ON, K7L 2V7, Canada.
Université de Montreal, C. P. 6128, succursale Centre-ville, Montréal, Québec, H3C 3J7, Canada; Department of Nephrology, CHU Sainte-Justine, 3175 ch. de la Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada.
Clin Nutr. 2020 Jun;39(6):1914-1918. doi: 10.1016/j.clnu.2019.08.014. Epub 2019 Aug 28.
Serum creatinine level is the most used test to evaluate renal function in patients with anorexia nervosa (AN). We investigated which formula of glomerular filtration rate (GFR) based on simple blood sample had the best correlation with the gold standard in malnourished adolescent patients with AN.
A prospective study was conducted on 34 adolescents hospitalized for the restrictive type of AN between 2014 and 2017. The GFR was measured by isotopic technique and calculated using the Cockroft-Gault, Schwartz equations and 3 other formula.
For the 34 AN patients, mean BMI -2.7 zscore, the mean measured GFR was 107+/-26 mL/min/1.73 m. Among them, 35% (12/34) had a GFR under 90 mL/min/1.73 m. The calculated GFR with Cockroft-Gault formula had the best correlation with the measured GFR (R2 = 0.852), whatever the creatinine level. No correlation was found between creatinine level and measured GFR.
Kidney dysfunction is common in malnourished AN adolescents, so clinicians should always evaluate AN patients for renal impairments. Creatinine level is a poor indicator of renal function in this population. The most accurate formula to test GFR with a simple blood test is the Cockroft-Gault formula.
血清肌酐水平是评估神经性厌食症(AN)患者肾功能最常用的检测方法。我们研究了基于简单血样的肾小球滤过率(GFR)公式中,哪一种与营养不良的青少年神经性厌食症患者的金标准相关性最好。
对 2014 年至 2017 年期间因限制型 AN 住院的 34 名青少年进行了前瞻性研究。使用同位素技术测量 GFR,并使用 Cockroft-Gault 方程和其他 3 种公式计算 GFR。
34 名 AN 患者的平均 BMI 为-2.7 z 评分,平均测量的 GFR 为 107+/-26 mL/min/1.73 m。其中,35%(12/34)的患者 GFR 低于 90 mL/min/1.73 m。无论肌酐水平如何,Cockroft-Gault 公式计算的 GFR 与测量的 GFR 相关性最好(R2=0.852)。肌酐水平与测量的 GFR 之间无相关性。
在营养不良的 AN 青少年中,肾功能障碍很常见,因此临床医生应始终评估 AN 患者的肾功能损害情况。在该人群中,肌酐水平是肾功能的一个较差指标。用简单的血液测试检测 GFR 最准确的公式是 Cockroft-Gault 公式。