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按年龄分层的肾小球滤过率指数的影响。

Effect of indexed glomerular filtration rate according to age.

机构信息

Radiopharmacy Unit, Nuclear Medicine Department, Hospital Universitario La Paz-IdiPAZ, Paseo de la Castellana 261, 20846, Madrid, Spain.

Radiopharmacy Unit, Nuclear Medicine Departament, Hospital Universitario, 12 de Octubre, Madrid, Spain.

出版信息

Clin Exp Nephrol. 2023 Jul;27(7):631-638. doi: 10.1007/s10157-023-02346-w. Epub 2023 May 4.

Abstract

BACKGROUND

To find out up to what age there is dispersion in glomerular filtration rate (GFR) values when normalised by body surface area (BSA) and extracellular fluid volume (ECFV), based on the hypothesis that these values differ in childhood age.

METHODS

A retrospective study was performed on patients aged 0-85 years, with renal pathology, who were administered i.v. 51Cr-EDTA. GFR was obtained using the Ham and Piepsz (children) or Christensen and Groth (adults) formula. Results were normalised by BSA and ECFV.

RESULTS

The cut-off point is defined as the age that discriminates between values ± 10 points apart. Using a ROC curve analysis, this age was set at 11.96 years with a sensitivity of 0.83 and a specificity of 0.85. The area obtained was 0.902 (95%CI 0.880-0.923). The results were corroborated by linear regression stratifying by age. For children under 12 years of age, the Pearson correlation was 0.883 (95% CI 0.860-0.902). For those aged 12 years or older, this coefficient was 0.963 (95%CI 0.957-0.968). According to our results, when normalising GFR by BSA and by ECFV there are different behaviours according to age.

CONCLUSION

For children older than 12 years both normalisation methods can be used, but for children younger than 12 years there are differences. We believe that in children under 12 years of age, GFR should be normalised by ECFV.

摘要

背景

根据儿童时期肾小球滤过率(GFR)值与体表面积(BSA)和细胞外液体积(ECFV)不成比例的假设,找出 GFR 值通过 BSA 和 ECFV 归一化时的离散度可以达到多大年龄。

方法

对年龄在 0-85 岁之间、接受静脉注射 51Cr-EDTA 的肾病理患者进行回顾性研究。使用 Ham 和 Piepsz(儿童)或 Christensen 和 Groth(成人)公式获得 GFR。结果通过 BSA 和 ECFV 归一化。

结果

截止点定义为区分值相差 10 个点的年龄。使用 ROC 曲线分析,该年龄设定为 11.96 岁,灵敏度为 0.83,特异性为 0.85。获得的面积为 0.902(95%CI 0.880-0.923)。通过按年龄分层的线性回归验证了这些结果。对于 12 岁以下的儿童,Pearson 相关系数为 0.883(95%CI 0.860-0.902)。对于 12 岁或以上的儿童,该系数为 0.963(95%CI 0.957-0.968)。根据我们的结果,当通过 BSA 和 ECFV 归一化 GFR 时,根据年龄会有不同的行为。

结论

对于 12 岁以上的儿童,可以使用这两种归一化方法,但对于 12 岁以下的儿童则存在差异。我们认为,在 12 岁以下的儿童中,GFR 应该通过 ECFV 进行归一化。

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