腎功能的評估：GFR測量與預測的理論和實務

The Evaluation of Renal Function: Estimation and Measurement of GFR (creatinine-based, cystatin C-based)

10.6340/KD.202312_35(4).0001

陳昱任(Yu-Jen Chen)；陳呈旭(Cheng-Hsu Chen)；吳明儒(Ming-Ju Wu)；蔡尚峰(Shang-Feng Tsai)

腎絲球過濾率 ； 肌肝酸清除率 ； 胱蛋白C ； MDRD公式 ； CKD-EPI公式 ； glomerular filtration rate ； creatinine clearance ； MDRD ； CKD-EPI ； cystatin C

腎臟與透析

35卷4期（2023 / 12 / 01）

159 - 162

繁體中文;英文

Glomerular filtration rate（GFR）是評估腎臟功能的主要指標，對於慢性腎臟病分期、急性腎損傷偵測、藥物劑量調整和腎臟移植捐贈者評估等領域至關重要。由於GFR的測量相對困難，而estimated GFR（eGFR）的判讀和應用受到患者臨床狀態和檢驗誤差的影響，成為醫療人員必不可少的技能。各式成人常用的eGFR計算方法，包括Cockcroft-Gault、MDRD到CKD-EPI等，逐漸提升了檢驗的信度和效度，引入Cystatin-C更進一步改善了公式的準確性。雖然各國發展出自己的MDRD和CKD-EPI公式，近年來歐美也開始反思使用種族校正參數的合理性。正確解讀腎功能將對預後、藥物治療效果和風險評估有更細膩的處理，從而提升醫療品質。

Glomerular filtration rate (GFR) is a key indicator for assessing kidney function, crucial in various areas such as staging chronic kidney disease, detecting acute kidney injury, adjusting drug dosages, and evaluating kidney transplant donors. Due to the inherent difficulty in measuring GFR, the interpretation and application of estimated GFR (eGFR) require indispensable skills from healthcare professionals. The evolution of commonly used eGFR calculations for adults, including the Cockcroft-Gault, MDRD, and CKD-EPI formulas, has progressively enhanced the reliability and validity of tests, with the introduction of Cystatin-C further refining accuracy. While each country has developed its own MDRD and CKD-EPI formulas, there is a growing reassessment of the rationality of incorporating racial parameters in recent years. Accurate interpretation of kidney function enables a more nuanced approach to prognosis, the effectiveness of drug therapies, and risk assessments, ultimately elevating the quality of healthcare.