Aufricht C, Balbisi A, Gerdov C, Müller T, Lothaller M A, Balzar E
Kinderdialyse, Univ. Kinderklinik Wien.
Klin Padiatr. 1995 Mar-Apr;207(2):59-62. doi: 10.1055/s-2008-1046512.
Despite many theoretical advantages, formula-creatininclearance (Schwartz et al, Journal of Pediatrics 1976) has not found broad clinical acceptance in everyday pediatric patient care. In this study we report our results of long term observations (11.7 +/- 6.8 (1.7-24.8) months) of measured and computed creatininclearance in 27 children after renal transplantation (15 boys, 12 girls, mean age 14.5 +/- 4.2 (5.5-20) years) at the Kinderdialyse of the Universitäts-Kinderklinik of Vienna. We found a wide scattered correlation between the measured and computed creatininclearance values with a 90% confidence interval between -30% to +60% of the 24 hour creatininclearance. Formula creatininclearance (SD 17.8%) was markedly better reproducable than the 24 hour creatininclearancethe (SD 37.8%), the intraindividuell collecting error (36.1%) was almost twice the interindividuell "coefficient" error (20.27%). We therefore conclude that the 24 hour creatininclearance is by far not as accurate as the complexity of the procedure pretends and support broad clinical acceptance for the formula creatininclearance.
尽管有许多理论优势,但公式计算的肌酐清除率(施瓦茨等人,《儿科学杂志》,1976年)在日常儿科患者护理中并未得到广泛的临床认可。在本研究中,我们报告了在维也纳大学儿童诊所的儿童透析中心对27例肾移植儿童(15名男孩,12名女孩,平均年龄14.5±4.2(5.5 - 20)岁)进行肌酐清除率测量和计算的长期观察结果(11.7±6.8(1.7 - 24.8)个月)。我们发现测量值与计算值之间的肌酐清除率存在广泛的离散相关性,24小时肌酐清除率的90%置信区间在 - 30%至 + 60%之间。公式计算的肌酐清除率(标准差17.8%)的可重复性明显优于24小时肌酐清除率(标准差37.8%),个体内收集误差(36.1%)几乎是个体间“系数”误差(20.27%)的两倍。因此,我们得出结论,24小时肌酐清除率远不如该检测程序所宣称的那么准确,并支持公式计算的肌酐清除率在临床上得到广泛认可。