Francesco Trevisani, Mariadelina Simeoni, A. Bettiga, A. Cinque, Matteo Floris
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引用次数: 0
摘要
摘要 本文深入探讨了精确测量肾小球滤过率(mGFR)在临床实践中的意义,强调了其在指导医疗决策和管理肾脏健康方面的重要作用,尤其是在肾癌(RC)患者接受肾毒性抗癌药物治疗的情况下。本文讨论了传统 GFR 估算方法(主要使用肌酐和胱抑素 C 等血清生物标记物)的局限性和优势,强调了这些方法在癌症患者中可能存在的不足。具体来说,专为癌症患者设计的较新的 GFR 估算公式在 RC 患者中的表现可能并不尽如人意。本文探讨了直接测量 GFR 的各种方法,包括黄金标准菊粉清除率和替代方法(如碘己醇血浆清除率)。本文最后强调,有必要继续研究和创新 GFR 测量方法,以改善患者的预后,尤其是有复杂医疗需求的人群。
Measurement of glomerular filtration rate in patients undergoing renal surgery for cancer: eGFR vs mGFR in the era of precision medicine.
BACKGROUND
In the era of precision medicine, determining reliable renal function assessment remains a critical and debatable issue, especially in nephrology and oncology.
SUMMARY
This paper delves into the significance of accurately measured Glomerular Filtration Rate (mGFR) in clinical practice, highlighting its essential role in guiding medical decisions and managing kidney health, particularly in the context of renal cancer (RC) patients undergoing nephrotoxic anti-cancer drugs. The limitations and advantages of traditional GFR estimation methods, primarily using serum biomarkers like creatinine and cystatin C, are discussed, emphasizing their possible inadequacy in cancer patients. Specifically, newer formulae designed for GFR estimation in cancer patients may not perform at best in RC patients. The paper explores various methods for direct GFR measurement, including the gold standard inulin clearance and alternatives like iohexol plasma clearance.
KEY MESSAGE
Despite the logistical challenges of these methods, their implementation is crucial for accurate renal function assessment. The paper concludes by emphasizing the need for continued research and innovation in GFR measurement methodologies to improve patient outcomes, particularly in populations with complex medical needs.
期刊介绍:
This journal comprises both clinical and basic studies at the interface of nephrology, hypertension and cardiovascular research. The topics to be covered include the structural organization and biochemistry of the normal and diseased kidney, the molecular biology of transporters, the physiology and pathophysiology of glomerular filtration and tubular transport, endothelial and vascular smooth muscle cell function and blood pressure control, as well as water, electrolyte and mineral metabolism. Also discussed are the (patho)physiology and (patho) biochemistry of renal hormones, the molecular biology, genetics and clinical course of renal disease and hypertension, the renal elimination, action and clinical use of drugs, as well as dialysis and transplantation. Featuring peer-reviewed original papers, editorials translating basic science into patient-oriented research and disease, in depth reviews, and regular special topic sections, ''Kidney & Blood Pressure Research'' is an important source of information for researchers in nephrology and cardiovascular medicine.