Single-Nephron Glomerular Filtration Rate in Healthy Adults.
Single-Nephron Glomerular Filtration Rate in Healthy Adults.
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DOI：
10.1056/nejmoa1614329
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发表时间：
2017-06-15
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影响因子：
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通讯作者：
Rule AD
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作者：
Denic A;Mathew J;Lerman LO;Lieske JC;Larson JJ;Alexander MP;Poggio E;Glassock RJ;Rule AD
肾小球滤过率（GFR）评估所有肾单位的功能，单肾单位GFR评估单个肾单位的功能。单肾单位GFR与人口统计学和临床特征以及人类肾脏活检结果的关系尚不清楚。我们确定了马约诊所和克利夫兰诊所的1388名活体肾脏供体，在供体评估期间使用造影剂进行了肾脏计算机断层扫描（CT）扫描，并进行了基于碘酞酸盐的GFR测量，并在捐赠时进行了肾脏活检。平均单肾单位GFR计算为GFR除以肾单位数量（计算为CT评估的双肾皮质体积乘以活检确定的肾小球密度）。人口统计学和临床特征以及活检结果与单肾单位GFR相关。总计58%的供体为女性，供体的平均（±SD）年龄为44±12岁。平均GFR为115±24 ml/min，平均肾单位数为860，000 ± 370，000个/肾，平均单肾单位GFR为80±40 nl/min。单肾单位GFR在年龄（供体年龄<70岁）、性别或身高（供体身高≤190 cm）方面无显著差异。较高的单肾单位GFR与活检中较大的肾单位、肾小球硬化和动脉硬化的发生率独立相关。较高的单肾单位GFR与身高超过190 cm、肥胖和终末期肾病家族史相关。在健康成人肾脏供体中，单肾单位GFR在年龄、性别和身高（如果≤190 cm）方面相当恒定。较高的单肾单位GFR与慢性肾脏疾病的某些危险因素和某些肾脏活检结果相关。（由国家糖尿病、消化和肾脏疾病研究所资助。
The glomerular filtration rate (GFR) assesses the function of all nephrons, and the single-nephron GFR assesses the function of individual nephrons. How the single-nephron GFR relates to demographic and clinical characteristics and kidney-biopsy findings in humans is unknown. We identified 1388 living kidney donors at the Mayo Clinic and the Cleveland Clinic who underwent a computed tomographic (CT) scan of the kidney with the use of contrast material and an iothalamate-based measurement of the GFR during donor evaluation and who underwent a kidney biopsy at donation. The mean single-nephron GFR was calculated as the GFR divided by the number of nephrons (calculated as the cortical volume of both kidneys as assessed on CT times the biopsy-determined glomerular density). Demographic and clinical characteristics and biopsy findings were correlated with the single-nephron GFR. A total of 58% of the donors were women, and the mean (±SD) age of the donors was 44±12 years. The mean GFR was 115±24 ml per minute, the mean number of nephrons was 860,000±370,000 per kidney, and the mean single-nephron GFR was 80±40 nl per minute. The single-nephron GFR did not vary significantly according to age (among donors <70 years of age), sex, or height (among donors ≤190 cm tall). A higher single-nephron GFR was independently associated with larger nephrons on biopsy and more glomerulosclerosis and arteriosclerosis than would be expected for age. A higher single-nephron GFR was associated with a height of more than 190 cm, obesity, and a family history of end-stage renal disease. Among healthy adult kidney donors, the single-nephron GFR was fairly constant with regard to age, sex, and height (if ≤190 cm). A higher single-nephron GFR was associated with certain risk factors for chronic kidney disease and certain kidney-biopsy findings. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases.)