Reder S, Hartmann H
Freien Universität Berlin, Deutschland.
Zentralbl Veterinarmed A. 1994 May;41(4):253-67.
Early diagnosis of loss in renal function (< 60-70%) is not possible either by resorting to the parameters of plasma urea and creatinine concentrations (responsive to functional loss by > 75% or by reference to urine concentration capacity (urine density: sensitive to concentrations > 60%). However, clearance techniques for determination of the glomerular filtration rate (GFR) have proved suitable for quantitative assessment of renal function. Endogenous creatinine clearance is one of the most common clinical approaches in GFR determination. Criticism of results obtainable from endogenous creatinine clearance appears to be justified by pharmacokinetic aspects of creatinine as an indicator, as well as by some of its analytical peculiarities. The tediousness of the procedure is another counterproductive aspect pertaining to large-scale use of endogenous creatinine clearance in veterinary medicine. Total blood-plasma clearance of exogenous creatinine (T-Clexo.Creatinine) would provide vets with an accurate (diagnostic validity) and practical method for carrying out clinical kidney-function diagnostics. However, more research on a number of related issues will be required before the general introduction of the procedure.
通过血浆尿素和肌酐浓度参数(对功能损失的反应>75%)或参考尿液浓缩能力(尿比重:对浓度>60%敏感),都无法早期诊断肾功能损失(<60 - 70%)。然而,用于测定肾小球滤过率(GFR)的清除技术已被证明适用于肾功能的定量评估。内源性肌酐清除率是GFR测定中最常见的临床方法之一。从药代动力学角度来看,肌酐作为一种指标以及其一些分析特性,似乎都证明了对内源性肌酐清除率结果的批评是合理的。该操作的繁琐性是在兽医学中大规模使用内源性肌酐清除率的另一个不利方面。外源性肌酐的全血 - 血浆清除率(T - Clexo.Creatinine)将为兽医提供一种准确(诊断有效性)且实用的临床肾功能诊断方法。然而,在该方法普遍应用之前,还需要对一些相关问题进行更多研究。