用无创方法评估肾小球滤过率

Sofiya Ruzhylo, Xawery Żukow, D. Popovych, Nataliya Zakalyak, H.Y. Kovalchuk, Yuriy Rohalya, Oleg Masnyi
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引用次数: 0

摘要

背景。现有的肾小球滤过率(GF)评估方法都是侵入性的。因此,我们设定了用无创方法评估肾小球滤过率的目标。材料和方法。观察对象是 10 名年龄在 37-69 岁之间、无临床诊断的男性,他们接受了两次测试,每次间隔 7 天。根据内源性肌酐清除率和 Cockcroft & Gault 公式计算肾小球滤过率。连续测量三次收缩压和舒张压。用心率变异法评估自律神经系统的状态。结果我们证实了 GF 与年龄和体重的显著相关性。筛查结果显示,血肌酐与一些血压和心率变异参数有明显的相关性。如果在经典公式中用收缩压和交感神经张力的心率变异指标代替肌酐血症,我们就可以得到一个估算 GF 的公式,其标准误差为 10.9 mL/min 对 2.7 mL/min,但不需要抽血。包括心率变异和血压参数以及尿肌酐浓度的回归模型可估算出 GF,标准误差为 12 毫升/分钟。结论浴疗法不仅对血肌酐水平有显著影响,对心率变异和血压参数也有影响,甚至更为明显。因此,仅根据 Cockcroft & Gault 公式估算 GF 至少不会比我们提出的方法更准确,而且我们的方法完全是非侵入性的。
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Assessment of the rate of glomerular filtration by a non-invasive method
Background. Existing methods for assessing glomerular filtration rate (GF) are invasive. Therefore, we set ourselves the goal of evaluating the rate of glomerular filtration by a non-invasive method. Materials and Methods. The object of observations were 10 men aged 37-69 years without clinical diagnosis tested twice with 7-days interval. The rate of glomerular filtration was calculated according to endogenous creatinine clearance and the Cockcroft & Gault formula. Systolic and diastolic blood pressure was measured three times in a row. The state of the autonomic nervous system was assessed by the HRV method. Results. We confirmed the significant correlation of GF with age and weight. The screening revealed a significant correlation of GF with a number of blood pressure and HRV parameters. If in the classic formula we replace creatinineemia with systolic blood pressure and HRV-markers of sympathetic tone, we get a formula for estimating the GF with a standard error of 10,9 mL/min vs 2,7 mL/min, but without blood sampling. The regression model, which includes HRV and blood pressure parameters, as well as urinary creatinine concentration, allows estimating GF with a standard error of 12 mL/min. Conclusion. The balneotherapy has a significant effect not only on blood creatinine level, but also on HRV and blood pressure parameters, and even more pronounced. Therefore, the estimation of GF based only on the Cockcroft & Gault formula is at least not much more accurate than the one proposed by us, besides, our method is completely non-invasive.
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