A simple method for correcting overestimated glomerular filtration rate in obese subjects evaluated by the Cockcroft and Gault formula: a comparison with 51Cr EDTA clearance.
A simple method for correcting overestimated glomerular filtration rate in obese subjects evaluated by the Cockcroft and Gault formula: a comparison with 51Cr EDTA clearance.
复制标题
一种通过 Cockcroft 和 Gault 公式评估的肥胖受试者校正高估肾小球滤过率的简单方法：与 51Cr EDTA 清除率的比较。
DOI：
10.5414/cnp62097
复制
发表时间：
2004
影响因子：
1.1
通讯作者：
P. Coratelli
中科院分区：
文献类型：
--
作者：
A. Saracino;Luigi Morrone;V. Suriano;A. Niccoli;A. Ramunni;M. Fanelli;Giuseppe Rubini;P. Coratelli
目标
Cockcroft和Gault公式是一种快速、可靠的方法，可以在不收集24小时尿液的情况下计算肌酐清除量(CG-CL)。在肥胖受试者中，过多的脂肪质量会导致每日每公斤体重的尿肌酸排泄量减少，并导致以CG-CL计算时高估肾功能。本研究的目的是设计一种简单的校正方法，同时也可以利用肥胖者的CG-CL。
患者和方法
在52名体重指数(BMI)为25的受试者中，通过同时测定24小时尿液(Cr-CL)和Cg-CL的内生肌酐清除量来评估肾功能。使用简单的线性回归分析，两个清除值之间的百分比差异(增量%)与每个患者的BMI相关。估计回归模型(增量%=1.217 BMI--24.81)提供了肥胖者的CG-CL校正公式：校正的CG-CL=CG-CL(1.25-0.012 BMI)。在另一组20名BMI>；25受试者中，通过比较校正的CG-CL和以~(51)Cr-EDTA(5Cr-EDTA-CL)的清晰度作为GFR测量金标准的CG-CL和MDRD公式(MDRD-CL)获得的结果，对其有效性进行评估。
结果与结论
将CG-CL、MDRD-CL和校正后的CG-CL与5tCr-EDTA-CL(作为自变量)进行线性回归分析，得到以下决定系数(R2)：0.687；0.818；0.947。结论：该公式可作为肥胖者CG-CL校正的一种快速、可靠的方法。
AIM
The Cockcroft and Gault formula is a quick and reliable method for calculating creatinine clearance without a 24-hour urine collection (CG-cl). In obese subjects an excess of fat mass provokes a reduction in daily creatinine urine excretion per body kilo weight and is responsible for overestimated renal function when calculated by CG-cl. The aim of this study was to devise a simple correction method which could also make use of CG-cl in obese subjects.
PATIENTS AND METHODS
In 52 subjects with a body mass index (BMI) > 25, renal function was assessed by simultaneously determining creatinine clearance using 24-hour urine collection (Cr-cl) and the CG-cl. The percentage difference between the 2 clearances (delta %) was correlated with BMI for each patient using simple linear regression analysis. The estimated regression model (delta% = 1.217 BMI-- 24.81) provided the following CG-cl correction formula for obese subjects: Corrected CG-cl = CG-cl (1.25 - 0.012 BMI). Its validity was evaluated in another group of 20 subjects with BMI > 25 by comparing the results obtained with Corrected CG-cl to those obtained by CG-cl and MDRD formula (MDRD-cl) using the clearance of 51Cr-EDTA (5 Cr-EDTA-cl) as the GFR measurement gold standard.
RESULTS AND CONCLUSION
Linear regression analysis of CG-cl, MDRD-cl and Corrected CG-cl compared to 5tCr-EDTA-cl (considered as the independent variable) resulted in the following determination coefficients (R2): 0.687; 0.818; 0.947, respectively. In conclusion, this formula can be considered a quick and reliable method for CG-cl correction in obese subjects.