Is it appropriate to index glomerular filtration rate for body surface area

Détails

ID Serval
serval:BIB_D59483FDF922
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Abstract (résumé de présentation): article court qui reprend les éléments essentiels présentés à l'occasion d'une conférence scientifique dans un poster ou lors d'une intervention orale.
Collection
Publications
Institution
Titre
Is it appropriate to index glomerular filtration rate for body surface area
Titre de la conférence
Annual meeting of the Swiss Society of Nephrology, Interlaken (Switzerland), December 2-4, 2009
Auteur(s)
Wuerzner G., Pruijm Menno, Maillard Marc, Bovet Pascal, Renaud Claude, Bochud Murielle, Burnier Michel
ISBN
1424-7860
Statut éditorial
Publié
Date de publication
2009
Peer-reviewed
Oui
Volume
139
Série
Swiss Medical Weekly
Pages
4S-5S
Langue
anglais
Notes
http://www.smw.ch/docs/PdfContent/smw-12950.pdf
Résumé
Purpose: Obesity is an established independent risk factor for chronic kidney disease. Thus, measurement of glomerular filtration rate (GFR) is important in this population. Traditionally, GFR has been indexed for body surface area (BSA), but this indexation may not be appropriate in obese individuals. Therefore, the objective of the study was to compare absolute GFR with GFR indexed for BSA and with GFR indexed for height.
Methods and materials: The study was conducted in 66 families from the Seychelles islands that included several members with hypertension. GFR and effective renal plasma flow (ERPF) were measured using inulin and PAH clearances, respectively. Antihypertensive treatment, if used, was withheld 2 weeks before conducting the clearances. Participants with diabetes mellitus were excluded from the analysis. BSA was calculated using the Dubois formula. We assessed trend across BMI categories using a non parametric test.
Results: Participants included 174 women and 127 men. The prevalence of hypertension was 61%, of which 68% were treated. The table shows that absolute GFR, GFR indexed for height, ERPF, filtration fraction were significantly higher across BMI categories. When GFR was indexed for BSA, the association between GFR and BMI categories was lost.
Conclusion: Indexing GFR for BSA in overweight and obese individuals leads to a substantial underestimation of GFR. Filtration fraction, which does not depend on BSA, is higher in obese individuals, which suggests glomerular hyperfiltration. Indexing GFR for BSA therefore would mask the underlying glomerular hyperfiltration. As the number of nephrons does not increase with weight gain, absolute GFR represents a better marker of single nephron GFR and is more appropriate.
Création de la notice
15/02/2010 13:21
Dernière modification de la notice
20/08/2019 16:55
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