Department of Medical Physics, Hunter New England Imaging, John Hunter Hospital, New Lambton Heights, NSW, Australia.
Phys Eng Sci Med. 2021 Dec;44(4):1331-1340. doi: 10.1007/s13246-021-01066-3. Epub 2021 Oct 25.
Glomerular filtration rate (GFR) varies with age, the calculation method, and the correction factor for slope-intercept overestimation. Hence, any normal reference range accompanying the results should be suitably adapted to the method used. For Nuclear Medicine Departments using a two-sample slope-intercept method, the lack of appropriate age-specific normal reference range has been a hindrance to adopting the recently updated Jodal Brochner-Mortensen (JBM) correction over other older and more widely used methods. A retrospective analysis of the routine GFR calculation and clinical reports generated locally from 2006 to 2020 was carried out. GFR was calculated with Tc-DTPA plasma clearance using a two-sample slope-intercept method with JBM correction. Age-specific normal range equations were developed from normal healthy subjects. Published normal reference ranges were modified with appropriate correction reversal and compared with the locally developed reference ranges. Age-specific normal GFR reference ranges for Tc-DTPA with slope-intercept method and JBM correction were developed and validated with current literature. Normal reference range (Mean ± 2SD) for Normalised GFR (ml min (1.73m)) within 95% confidence limits suitable for use with JBM correction is 100.6 ± 35.2 for children above 2 years and 102.9 - 0.00629 × (Age) ± 19.4 for adults. Availability of age-specific normal GFR reference ranges applicable to the target population and appropriately tailored to the calculation method and correction factor enables Nuclear Medicine Departments to update their calculation methods in line with the current literature and also facilitates accurate reporting and evaluation of the calculated GFR results.
肾小球滤过率 (GFR) 随年龄、计算方法和斜率截距高估的校正因子而变化。因此,任何伴随结果的正常参考范围都应根据所用方法进行适当调整。对于使用两样本斜率截距法的核医学科,缺乏适当的年龄特异性正常参考范围一直是采用最近更新的 Jodal Brochner-Mortensen (JBM) 校正法而不是其他更老和更广泛使用的方法的障碍。对 2006 年至 2020 年期间本地生成的常规 GFR 计算和临床报告进行了回顾性分析。使用 Tc-DTPA 血浆清除率的两样本斜率截距法进行 GFR 计算,并采用 JBM 校正。从正常健康受试者中开发出年龄特异性正常范围方程。对发布的正常参考范围进行了适当的校正反转,并与本地开发的参考范围进行了比较。使用 Tc-DTPA 斜率截距法和 JBM 校正开发并验证了年龄特异性正常 GFR 参考范围,这些参考范围与当前文献一致。适合使用 JBM 校正的当前文献中,年龄特异性正常 GFR 参考范围(均数±2SD)为 100.6±35.2,适用于 2 岁以上儿童,适用于成人的正常化肾小球滤过率(ml min(1.73m))正常参考范围(95%置信区间内的均值±2SD)为 102.9-0.00629×(年龄)±19.4。适用于目标人群的年龄特异性正常 GFR 参考范围的可用性以及针对计算方法和校正因子进行的适当调整,使核医学科能够根据当前文献更新其计算方法,还便于准确报告和评估计算的 GFR 结果。