肾小球滤过率测定方法的研究进展

Research progress on measurement methods of glomerular filtration rate

摘要

肾小球滤过率(glomerular filtration rate,GFR)是评估肾功能的核心指标,其准确测量对临床前及临床研究和基础研究至关重要。本文系统综述了GFR检测方法的研究进展,包括内源性标志物(肌酐、尿素氮、胱抑素C)和外源性标志物[菊粉、碘己醇、异硫氰酸荧光素(fluorescein isothiocyanate,FITC)-甘菊素、放射性标记物]的应用以及活体荧光成像等新兴技术。内源性标志物检测操作简便,但易受非肾脏因素干扰,准确性有限;外源性标志物中,菊粉虽为“金标准”,但检测操作流程烦琐,FITC-甘菊素和碘己醇在无创性与准确性之间取得了平衡,但仍需优化;新兴技术如多光子高分辨率荧光成像可实现单肾单位GFR动态监测,但整体肾功能评估仍存在挑战,未来发展方向应聚焦无创、高精度、可连续监测的方法。本文为肾功能研究提供了方法学参考,并展望技术创新趋势,以期为临床前及临床研究肾功能和开发GFR监测技术的相关人员提供参考。

Abstract

Glomerular filtration rate (GFR) serves as a critical indicator for assessing renal function, and its accurate measurement is essential for preclinical studies, clinical research, and fundamental research. This article systematically reviews the recent advances in GFR detection methods, including the application of endogenous markers (creatinine, blood urea nitrogen, and cystatin C) and exogenous markers (inulin, iohexol, fluorescein isothiocyanate (FITC)-sinistrin, and radiolabeled compounds), as well as emerging techniques such as in vivo fluorescence imaging. While endogenous markers offer operational convenience, their accuracy is limited by susceptibility to non-renal factors. Among exogenous markers, although inulin is the gold standard, its procedure is cumbersome, whereas FITC-inulin and iohexol achieve a balance between non-invasiveness and accuracy but still require optimization. Emerging technologies, such as multiphoton high-resolution fluorescence imaging, enable dynamic monitoring of single-nephron GFR, although challenges persist in the assessment of overall renal function. Future development should focus on non-invasive, high-precision, and continuous monitoring approaches. This article provides methodological references for renal function research and discusses future trends in technological innovation, aiming to serve as a reference for those involved in preclinical and clinical studies of renal function and the development of GFR monitoring techniques.

关键词

肾功能评估 / 肾小球滤过率 / 内源性标志物 / 外源性标志物 / 荧光成像

Key words

renal function assessment / glomerular filtration rate / endogenous markers / exogenous markers / fluorescence imaging

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