Gates 방법과 혈청 크레아티닌을 이용한 사구체 여과율의 비교

Comparison of Glomerular Filtration Rate Using Gates Method and Serum Creatinine

Purpose: Glomerular filtration rate (GFR) is considered as the best overall index for the level of renal function, diagnosis of doubtful kidney disease, progress observation from chronic kidney disease and is measured with the various methods. In this study, We measured standard GFR by Gates method and attempted to compare the result with serum creatinin-based, Cockcroft-Gault(C-G) formula and Modification of Diet in Renal Disease (MDRD) formula. Materials and methods: 217 patients (127 men, 90 women, mean age 51.3±16.9) with various renal function were examined. we compared the GFR using ⁹⁹ᵐTc-DTPA (Gates), C-G formula and MDRD formula. Results: Significant correlations were noted between 2 different GFR estimates (from C-G formula: r=0.864, p<0.0001, MDRD formula: r=0.831, p<0.0001) and ⁹⁹ᵐTc-DTPA (Gates) GFR. Average of serum creatinine (Scr) was measured with 3.0±3.1 mg/dL, In patients with normal renal function (Scr<1.5 mg/dL), ⁹⁹ᵐTc-DTPA (Gates) GFR was statistically significant to C-G formula (p<0.0001) and MDRD formula (p<0.0001). In patients with mild to moderate renal insufficiency (1.5<Scr<4.0 mg/dL), ⁹⁹ᵐTc-DTPA (Gates) GFR was not statistically significant to C-G formula (p=0.181) and MDRD formula (p=0.127). In patients with severe renal insufficiency (Scr>4.0mg/dL), ⁹⁹ᵐTc-DTPA (Gates) GFR was statistically significant to C-G formula and MDRD formula (p<0.0001). Conclusions: Glomerular filtration rate using Gates method was closly correlated to C-G formula and MDRD formula. In patients with normal renal function, ⁹⁹ᵐTc-DTPA (Gates) GFR was significantly lower than C-G formula and MDRD formula. In patients with mild to moderate renal insufficiency, ⁹⁹ᵐTc-DTPA (Gates) GFR was simmilar with C-G formula and MDRD formula. In patients with severe renal insufficiency, ⁹⁹ᵐTc-DTPA (Gates) GFR was significantly higher than C-G formula and MDRD formula. None of the three different methods was clearly superior to the others.