The reliability of different formulae to predict creatinine clearance
The reliability of different formulae to predict creatinine clearance
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DOI：
10.1046/j.1365-2796.2003.01141.x
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发表时间：
2003-05-01
影响因子：
11.1
通讯作者：
De Jong, PE
中科院分区：
文献类型：
--
作者：
Verhave, JC;Baljé-Volkers, CP;De Jong, PE
目标.肌酐清除率（CCR）是临床上常用的测量肾小球滤过率（GFR）的工具。这个工具需要收集24小时的尿液，这是相当麻烦的。已经使用几种不同的公式来估计GFR，使用血浆肌酐和其他容易的公式来获得生物统计数据。我们检查了10个公式，并将它们与在大样本的一般人群中实际测量的CCR进行了比较。横断面队列研究。大学医院门诊，一项基于人群的研究。格罗宁根市共有8592名居民，年龄在28-75岁之间。该队列富含微量白蛋白尿。一般来说，公式不能准确估计CCR，尤其是在男性和肥胖受试者中。包括Cockcroft-Gault在内的六个公式在总体人群和特定性别、体重指数和年龄的亚组中对CCR进行了相当好的估计。然而，所有的公式，给出了一个低估的测量CCR在CCR的较高范围和高估在较低的范围。此外，CCR的年龄相关性下降很难用公式近似。我们的结论是，公式估计CCR在一般人群中，虽然提供了一个相当好的估计平均CCR，不提供可靠的数据CCR的上限和下限范围，并没有充分估计年龄相关的下降CCR。
Objectives. Creatinine clearance (CCR) is a commonly used tool to measure glomerular filtration rate (GFR) in clinical practice. This tool requires collection of 24-h urine, which is quite bothersome. Several different formulae have been used to estimate GFR using plasma creatinine and other easy formulae to obtain biometrical data. We examined 10 formulae and compared them with actually measured CCR in a large sample of the general population.Design. Cross-sectional cohort study.Setting. University hospital outpatient clinic, a population based study.Subjects. A total of 8592 inhabitants of the city of Groningen, 28-75 years of age. The cohort is enriched for microalbuminuria.Results. In general, the formulae did not give an accurate estimation of CCR, particularly not in male and in obese subjects. Six formulae, including the Cockcroft-Gault gave a fairly good estimation of CCR in the overall population and in subgroups of specific gender, body mass index and age. All formulae however, gave an underestimation of the measured CCR in higher ranges of CCR and an overestimation in the lower ranges. Moreover, the age-related decline of CCR is hard to approximate with a formula.Conclusions. We conclude that formulae to estimate CCR in the general population, although giving a fairly good estimate of mean CCR, do not offer reliable data on CCR in the upper and lower ranges and do not adequately estimate the age-related decline in CCR.