Сравнение различных методик определения остаточной функции почек

THE AIM of the work was to compare different techniques of determining the residual renal function for the establishment of the most reliable criterion of selection of patients for beginning the substitution renal therapy (SRT). PATIENTS AND METHODS. A retrospective comparative analysis of three means of determining the residual renal function was made in 208 patients with the terminal stage of chronic renal failure in three dialysis centers of St.Petersburg at the period from 1986 through 2004. RESULTS. It was found that the values of creatinine clearance determined by two methods (with the Rehberg test and by the formula CockcroftGault) differed from the values of the glomerular filtration rate (GFR) calculated by MDRD formula. The index of survival of dialysis patients was used in order to determine the prospective value of the calculation methods. Mathematically it was confirmed that among the methods of determining the excretory function of the kidneys the GFR indices calculated by the MDRD formula were the only significant predictor of lethality independent of stratification. CONCLUSION. It was convincingly shown that the determination of the residual renal function values calculated by GFR using the modified MDRD formula allows the development of common criteria for correct selection of patients for the beginning of dialysis. The values calculated by MDRD formula are the only ones from the investigated indices of the residual function of the kidneys at the start of SRT influencing the survival of dialysis patients.