کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
8769653 | 1597998 | 2018 | 10 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Kidney Function in Obesity-Challenges in Indexing and Estimation
ترجمه فارسی عنوان
عملکرد کلیه در چالش های چاقی در نمایه سازی و برآورد
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کلمات کلیدی
موضوعات مرتبط
علوم پزشکی و سلامت
پزشکی و دندانپزشکی
بیماریهای کلیوی
چکیده انگلیسی
As the prevalence of obesity continues to increase worldwide, an increasing number of people are at risk for kidney disease. Thus, there is a critical need to understand how best to assess kidney function in this population, and several challenges exist. The convention of indexing glomerular filtration rate (GFR) to body surface area (BSA) attempts to normalize exposure to metabolic wastes across populations of differing body size. In obese individuals, this convention results in a significantly lower indexed GFR than unindexed GFR, which has practical implications for drug dosing. Recent data suggest that “unindexing” estimated GFR (multiplying by BSA/1.73Â m2) for drug dosing may be acceptable, but pharmocokinetic data to support this practice are lacking. Beyond indexing, biomarkers commonly used for estimating GFR may induce bias. Creatinine is influenced by muscle mass, whereas cystatin C correlates with fat mass, both independent of kidney function. Further research is needed to evaluate the performance of estimating equations and other filtration markers in obesity, and determine whether unindexed GFR might better predict optimal drug dosing and clinical outcomes in patients whose BSA is very different than the conventional normalized value of 1.73Â m2.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Advances in Chronic Kidney Disease - Volume 25, Issue 1, January 2018, Pages 31-40
Journal: Advances in Chronic Kidney Disease - Volume 25, Issue 1, January 2018, Pages 31-40
نویسندگان
Alex R. Chang, Waleed Zafar, Morgan E. Grams,