肾脏疾病中的肌酐清除率。重新评估。
Creatinine clearance in renal disease. A reappraisal.
作者信息
Kim K E, Onesti G, Ramirez O, Brest A N, Swartz C
出版信息
Br Med J. 1969 Oct 4;4(5674):11-4. doi: 10.1136/bmj.4.5674.11.
Abstract
To determine the validity of endogenous creatinine clearance as a measure of glomerular filtration rate in patients with renal disease 308 simultaneous determinations of inulin clearance and endogenous creatinine clearance were reviewed and analysed. The ratio of creatinine clearance/inulin clearance increased progressively with the decline in inulin clearance, while the finding of a normal endogenous creatinine clearance masked a definite but mild decrease of glomerular filtration rate in 42% of the patients and a moderate decrease of glomerular filtration rate in 23%. This indicates that with declining glomerular filtration rates the endogenous creatinine clearance progressively overestimates actual glomerular filtration rates. Hence a single determination of creatinine clearance can be misleading as a screening measurement of glomerular filtration rate.
摘要
为了确定内源性肌酐清除率作为肾病患者肾小球滤过率指标的有效性，我们回顾并分析了308例菊粉清除率与内源性肌酐清除率的同步测定结果。肌酐清除率与菊粉清除率的比值随着菊粉清除率的下降而逐渐升高，同时，内源性肌酐清除率正常的结果掩盖了42%的患者肾小球滤过率有明确但轻微的下降，以及23%的患者肾小球滤过率有中度下降的情况。这表明随着肾小球滤过率下降，内源性肌酐清除率会逐渐高估实际的肾小球滤过率。因此，单次测定肌酐清除率作为肾小球滤过率的筛查指标可能会产生误导。
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