Sawyer W T, Canaday B R, Poe T E, Webb C E, Gal P, Joyner P U, Berry J I
Am J Hosp Pharm. 1983 Dec;40(12):2175-80.
Patient data were analyzed retrospectively to evaluate the relationship between several body-weight variables and creatinine production and clearance. Data from 722 creatinine clearance determinations in 627 patients older than 12 years were analyzed. Weight variables were actual body weight (ABW), lean body weight (LBW), ideal body weight (IBW), and lean body mass (LBM). Weight-independent and weight-dependent clearance prediction methods were evaluated. Actual creatinine clearance values were compared with these predictions. Use of LBW and IBW produced equivalent estimates of creatinine clearance that were closer to measured values than those obtained with ABW. The use of LBW or IBW was not appropriate in patients less than 60 inches tall nor in morbidly obese patients. Weight-dependent clearance estimation was superior to weight-independent predictions in morbidly obese patients. A new LBM-based clearance estimation formula was derived; it may be useful for patients less than 60 inches tall. The use of LBM, particularly in patients less than 60 inches tall, should be investigated further.
对患者数据进行回顾性分析，以评估多个体重变量与肌酐生成及清除之间的关系。分析了627名12岁以上患者的722次肌酐清除率测定数据。体重变量包括实际体重（ABW）、瘦体重（LBW）、理想体重（IBW）和瘦体重指数（LBM）。对与体重无关和与体重有关的清除率预测方法进行了评估。将实际肌酐清除率值与这些预测值进行比较。使用LBW和IBW得出的肌酐清除率估计值相当，且比使用ABW得出的估计值更接近测量值。对于身高不足60英寸的患者或病态肥胖患者，使用LBW或IBW并不合适。在病态肥胖患者中，与体重有关的清除率估计优于与体重无关的预测。推导了一个新的基于LBM的清除率估计公式；它可能对身高不足60英寸的患者有用。LBM的应用，尤其是在身高不足60英寸的患者中的应用，应进一步研究。
