NDT Advance Access originally published online on October 2, 2007
Nephrology Dialysis Transplantation 2008 23(1):4-6; doi:10.1093/ndt/gfm662
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Glomerular filtration rate—what is the rationale and justification of normalizing GFR for body surface area?
1Renal Unit, Western Infirmary, Glasgow, United Kingdom and 2Renal Unit, Inverclyde Royal Hospital, Greenock, United Kingdom
Correspondence and offprint requests to: Dr Colin Geddes, Consultant Nephrologist, Renal Unit, Level 7, Western Infirmary, Dumbarton Road, Glasgow G11 6NT, United Kingdom. Tel: +44-141-211-2521; Fax: +44-141-211-1711; E-mail: colin.geddes@northglasgow.scot.nhs.uk
Keywords: body surface area; children; chronic kidney disease; extracellular fluid volume; glomerular filtration rate; living kidney donor
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Introduction |
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We were presented with a 54-year-old man who wished to donate a kidney to his 21-year-old son who had established renal failure. Live donor work up of the father was satisfactory except for borderline kidney function; glomerular filtration rate (GFR) measured by plasma clearance of 51Cr[EDTA] was 87.0 ml/min uncorrected for body surface area (BSA) and 77.9 ml/min/1.73 m2. Should kidney donation proceed? Published international guidelines [1] and UK guidelines [2] recommend a minimum GFR of 80 ml/min/1.73 m2 and 75 ml/min/1.73 m2 respectively for a 55-year-old prospective kidney donor. The 9.1 ml/min difference between the absolute GFR and the GFR indexed for BSA prompted further consideration of the validity and rationale for indexing GFR to BSA.
There are several formulae that estimate BSA from measures of height and weight in the literature and in this man, with height 1.65 m and weight 86 kg,
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Is body surface area the appropriate index for GFR? |
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Are estimates of BSA using height and weight valid? |
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Why does BSA continue to be used to index GFR in clinical practice? |
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Should ECFV be used to index GFR instead of BSA? |
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What should be done? |
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