NDT Advance Access originally published online on July 19, 2005
Nephrology Dialysis Transplantation 2005 20(10):2024-2028; doi:10.1093/ndt/gfh983
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Editorial Comment
Indexing glomerular filtration rate for body surface area in obese patients is misleading: concept and example
1 Department of Nephrology, 2 Department of Diabetes, Nutrition and Metabolic Disorders, and 3 Department of Nuclear Medicine CHU Sart Tilman, University of Liège, Belgium
Correspondence and offprint requests to: Pierre Delanaye, Department of Nephrology, CHU Sart Tilman, Liège, Belgium. Email: pierre_delanaye@yahoo.fr
Keywords: glomerular filtration rate; body surface area; obesity
| The first 150 words of the full text of this article appear below. |
 |
Introduction |
|---|
Indexing physiological data such as the glomerular filtration rate (GFR) for body surface area (BSA) has two major goals: allowing direct comparison of these data in patients with different body size and also defining values that will be considered as normal [1,2]. The use of BSA for indexing GFR is old and it has become so conventional that one can talk about indexing for BSA as ‘an icon’ in nephrology [3]. Nevertheless, the practice is not immune from criticisms, especially in a population with unusual anthropometric data such as the obese population.
|
History: more than a century ago ... |
|---|
In the late 19th century, physiologists thought that the metabolic rate was proportional to the BSA [4]. Now we know that this assertion is not exact [5–7] but, at that time, it was considered as a law. Measurement of metabolic rate with direct calorimetry is complex. Since 1879,
|
Indexing GFR for BSA in a ‘normal’ body size population |
|---|
|
Indexing GFR for BSA in obese patients |
|---|
|
Other ways to index the GFR? |
|---|
|
Conclusion |
|---|
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  P. Delanaye, C. Mariat, E. Cavalier, and J.-M. Krzesinski Errors induced by indexing glomerular filtration rate for body surface area: reductio ad absurdum Nephrol. Dial. Transplant., December 1, 2009; 24(12): 3593 - 3596. [Full Text] [PDF]
|
|
|
|
|
|
D. Tsinalis and G. T. Thiel An easy to calculate equation to estimate GFR based on inulin clearance Nephrol. Dial. Transplant., October 1, 2009; 24(10): 3055 - 3061. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Gerchman, J. Tong, K. M. Utzschneider, S. Zraika, J. Udayasankar, M. J. McNeely, D. B. Carr, D. L. Leonetti, B. A. Young, I. H. de Boer, et al. Body Mass Index Is Associated with Increased Creatinine Clearance by a Mechanism Independent of Body Fat Distribution J. Clin. Endocrinol. Metab., October 1, 2009; 94(10): 3781 - 3788. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. D. Navaneethan, H. Yehnert, F. Moustarah, M. J. Schreiber, P. R. Schauer, and S. Beddhu Weight Loss Interventions in Chronic Kidney Disease: A Systematic Review and Meta-analysis Clin. J. Am. Soc. Nephrol., October 1, 2009; 4(10): 1565 - 1574. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Glassock and C. G. Winearls eGFR: Readjusting Its Rating Clin. J. Am. Soc. Nephrol., May 1, 2009; 4(5): 867 - 869. [Full Text] [PDF]
|
|
|
|
 |
|
 D. Scrutinio, A. Passantino, D. Santoro, E. Cacciapaglia, and G. Farinola Prognostic value of formulas estimating excretory renal function in the elderly with systolic heart failure Age Ageing, May 1, 2009; 38(3): 296 - 301. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Delanaye, E. Cavalier, M. Froissart, and J. M. Krzesinski Reproducibility of GFR measured by chromium-51-EDTA and iohexol Nephrol. Dial. Transplant., December 1, 2008; 23(12): 4077 - 4078. [Full Text] [PDF]
|
|
|
|
|
|
F. W. Visser, J. H. J. Muntinga, R. A. Dierckx, and G. Navis Feasibility and Impact of the Measurement of Extracellular Fluid Volume Simultaneous with GFR by 125I-Iothalamate Clin. J. Am. Soc. Nephrol., September 1, 2008; 3(5): 1308 - 1315. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. C. Geddes, Y. M. Woo, and S. Brady Glomerular filtration rate what is the rationale and justification of normalizing GFR for body surface area? Nephrol. Dial. Transplant., January 1, 2008; 23(1): 4 - 6. [Full Text] [PDF]
|
|
|
|
|
|
C. Mariat, N. Maillard, M. Phayphet, L. Thibaudin, S. Laporte, E. Alamartine, and F. Berthoux Estimated glomerular filtration rate as an end point in kidney transplant trial: where do we stand? Nephrol. Dial. Transplant., January 1, 2008; 23(1): 33 - 38. [Full Text] [PDF]
|
|
|
|
 |
|
 P. Delanaye, J. M. Krzesinski, and E. Cavalier Letter by Delanaye et al Regarding Article, "Drawbacks and Prognostic Value of Formulas Estimating Renal Function in Patients With Chronic Heart Failure and Systolic Dysfunction" Circulation, March 20, 2007; 115(11): e333 - e333. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Navarro-Diaz, A. Serra, R. Romero, J. Bonet, B. Bayes, M. Homs, N. Perez, and J. Bonal Effect of Drastic Weight Loss after Bariatric Surgery on Renal Parameters in Extremely Obese Patients: Long-Term Follow-Up J. Am. Soc. Nephrol., December 1, 2006; 17(12_suppl_3): S213 - S217. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Rigalleau, P. Chauveau, C. Lasseur, C. Perlemoine, N. Barthe, C. Raffaitin, C. Combe, and H. Gin Indexing glomerular filtration rate for body surface area is useful in obese subjects Nephrol. Dial. Transplant., March 1, 2006; 21(3): 821 - 821. [Full Text] [PDF]
|
|
|
|
|
|
P. Delanaye, G. Depas, R. P. Radermecker, M. Rorive, and J. M. Krzesinski Reply Nephrol. Dial. Transplant., March 1, 2006; 21(3): 821 - 822. [Full Text] [PDF]
|
|