Nephron Clinical Practice
Original Paper
Estimated Lean Body Mass Is More Appropriate than Body Surface Area for Scaling Glomerular Filtration Rate and Extracellular Fluid VolumePeters A.M.a · Snelling H.L.R.a · Glass D.M.b · Love S.d · Bird N.J.cDepartments of Nuclear Medicine,aRoyal Sussex County Hospital, Brighton, bHarley St. Clinic, London, and cAddenbrooke’s Hospital, Cambridge, and dDepartment of Medicine, Addenbrooke’s Hospital, Cambridge, UK
|
|
Log in to MyKarger to check if you already have access to this content.
KAB
Buy a Karger Article Bundle (KAB) and profit from a discount!
If you would like to redeem your KAB credit, please log in.
Save over 20% compared to the individual article price.
Subscribe
For eJournal Archive and eJournal Backfiles information please contact Karger service
Article / Publication Details
Received: October 25, 2009
Accepted: January 10, 2010
Published online: May 21, 2010
Issue release date: August 2010
Number of Print Pages: 1
Number of Figures: 3
Number of Tables: 2
eISSN: 1660-2110 (Online)
For additional information: https://www.karger.com/NEC
Abstract
Background/Aims: To compare body surface area (BSA) with lean body mass (LBM) for scaling extracellular fluid volume (ECV) and glomerular filtration rate (GFR). Methods:Phase 1: Total body water (TBW), bromide space and LBM were measured with 3H-water, 77Br and dual X-ray absorptiometry, respectively, in 6 healthy adults. Phase 2: ECV and GFR were measured with 51Cr-EDTA in 95 healthy adults and 56 children (0.5–13 years). ECV was calculated as GFR divided by GFR/ECV, both corrected for the one-compartment assumption. LBM was estimated (eLBM) in adults from height and weight and in children using a height/weight formula for estimating ECV and a constant derived from a separate adult population relating ECV to eLBM. Results:Phase 1: LBM and BSA correlated closely with TBW and bromide space. With LBM, the regressions passed through the origin, but with BSA, the intercepts were significantly below zero. Phase 2: GFR/BSA and ECV/BSA were higher in men than women but no difference was recorded in GFR/eLBM, GFR/ECV or ECV/eLBM. ECV showed a linear relation with eLBM and a non-linear relation with BSA. GFR/BSA and ECV/BSA correlated significantly with BSA but neither GFR/eLBM nor ECV/eLBM correlated with eLBM. Conclusion: eLBM is preferable to BSA for scaling GFR and ECV.
© 2010 S. Karger AG, Basel
Related Articles:
References
- McCance RA, Widdowson EM: The correct physiological basis on which to compare infant and adult renal function. Lancet 1952;1:860–862.
- Turner ST, Reilly SL: Fallacy of indexing renal and systemic hemodynamic measurements for body surface area. Am J Physiol 1995;268:R978–R988.
- Anastasio P, Spitali L, Frangiosa A, Molino D, Stellato D, Cirillo E, et al: Glomerular filtration rate in severely overweight normotensive humans. Am J Kidney Dis 2000;35:1144–1148.
- Bird NJ, Henderson BL, Lui D, Ballinger JR, Peters AM: Indexing glomerular filtration rate to suit children. J Nucl Med 2003;44:1037–1043.
- Peters AM: Expressing glomerular filtration rate in terms of extracellular fluid volume. Nephrol Dial Transplant 1992;7:205–210.
- Boer P: Estimated lean body mass as an index for normalization of body fluid volumes in man. Am J Physiol 1984;247:F632–F635.
- Skrabal F, Arnot RN, Helus F, Glass HI, Joplin GF: A method for simultaneous electrolyte investigations in man using 77Br, 43K and 24Na. Int J Appl Radiat Isot 1970;21:183–191.
-
Veal N, Vetter H: Radioisotope Techniques in Clinical Research and Diagnosis. London, Butterworth, 1958.
- Prentice TC, Siri W, Berlin NI, Hyde GM, Parsons RJ, Joiner EE, Lawrence JH: Studies of total body water with tritium. J Clin Invest 1952;31:412–418.
- Engelen MP, Schols AM, Heidendal GA, Wouters EF: Dual-energy X-ray absorptiometry in the clinical evaluation of body composition and bone mineral density in patients with chronic obstructive pulmonary disease. Am J Clin Nutr 1998;68:1298–1303.
- Haycock GB, Schwarz GJ, Wisotsky DH: Geometric method for measuring body surface area: a height-weight formula validated in infants, children and adults. J Pediatr 1978;93:62–66.
- Brochner-Mortensen J: A simple method for the determination of glomerular filtration rate. Scand J Clin Lab Invest 1972;30:271–274.
- Bird NJ, Peters C, Michell AR, Peters AM: Suitability of a simplified technique based on iohexol for de-centralised measurement of glomerular filtration rate. Scand J Urol Nephrol 2008;42:472–480.
- Bird NJ, Michell AR, Peters AM: Accurate measurement of extracellular fluid volume from the slope/intercept technique after bolus injection of a filtration marker. Physiol Meas 2009;30:1371–1379.
-
Rathbun EN, Pace N: Studies on body composition. I. The determination of total body fat by means of the body specific gravity. J Biol Chem 1945;158:667–676.
External Resources
- Hume R, Weyers E: Relationship between total body water and surface area in normal and obese subjects. J Clin Pathol 1971;24:234–238.
- Womersley J, Boddy K, King PC, Durnin JV: Estimation of the fat-free mass of twenty subjects from measurements of total body potassium, body density, skinfold thickness, and height and weight. Proc Nutr Soc 1972;31:35A.
- Absalom AR, Mani V, De Smet T, Struys MM: Pharmacokinetic models for propofol – defining and illuminating the devil in the detail. Br J Anaesth 2009;103:26–37.
-
Wesson LG: Renal function; in Wesson LG (ed): Physiology of the Human Kidney. New York, Grune & Stratton, 1969.
- Grewal GS, Blake GM: Reference data for 51Cr-EDTA measurements of the glomerular filtration rate derived from live kidney donors. Nucl Med Commun 2005;26:61–65.
- Brochner-Mortensen J: The extracellular fluid volume of normal man determined as the distribution volume of 51Cr-EDTA. Scand J Clin Lab Invest 1982;42:261–264.
- Delanaye P, Radermecker RP, Rorive M, Depas G, Krzesinski JM: Indexing glomerular filtration rate for body surface area in obese patients is misleading: concept and example. Nephrol Dial Transplant 2005;20:2024–2028.
Article / Publication Details
Received: October 25, 2009
Accepted: January 10, 2010
Published online: May 21, 2010
Issue release date: August 2010
Number of Print Pages: 1
Number of Figures: 3
Number of Tables: 2
eISSN: 1660-2110 (Online)
For additional information: https://www.karger.com/NEC
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Get Permission
PubMed ID
