肾小球滤过率测量方法的研究进展

Research progress in the measurement of glomerular filtration rate

肾小球滤过率(GFR)反映肾脏的滤过功能,其定义为单位时间内从肾脏滤出的血浆量,这无法直接测量,只能通过具有特定性质的物质的清除率来间接测量。目前逐渐被推广使用的基于肌酐和(或)胱抑素C估算的GFR,其估算公式均是以物质清除率测量的GFR为标准拟合出来的数学公式。不同估算公式参照的GFR测量方法不同,有可能会导致在估算GFR时产生差异。本文就物质清除率测量GFR的几个要素,包括物质特性、清除率类型、血浆清除率的采血次数及时间点、不同GFR测量方法间的比较等做一综述,并对新型GFR测量物质进行简要介绍。碘海醇血浆清除率因其可操作性、易标准化、易推广而具有良好的应用前景。代谢组学有可能发现新的标志物用于GFR的测量。

The glomerular filtration rate,which reflects the filtration function of kidney,is defined as the amount of plasma filtered from the kidney per unit of time.It cannot be measured directly,but only indirectly by the clearance rate of substances with specific properties.At present,the estimated GFR based on creatinine and(or)cystatin C has been gradually popularized,and its estimated formulas are all mathematical fitting formulas based on measured GFR.Different estimated formulas refer to different GFR measurement methods,which may lead to differences in GFR estimation.In this paper,several factors of GFR measurement by the clearance rate of substances,including material characteristics,clearance types,blood collection times and time points of plasma clearance,and comparison of different GFR measurement methods,are reviewed,and the new GFR measurement materials are briefly introduced.The plasma clearance of iohexol has a good application prospect because of its operability,easy standardization and promotion.Metabolomics has the potential to discover new markers for the measurement of GFR.