Document Detail


Prediction of colloid osmotic pressure in renal patients.
MedLine Citation:
PMID:  10809414     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Colloid osmotic pressure (COP) plays a major role in transcapillary fluid shift, including in the glomerular capillary. However, COP is generally estimated by quadratic equations derived from total plasma protein and/or albumin concentrations. The aim of this study was to assess the accuracy of such equations, and to determine the potential role of liver-derived non-albumin proteins in the maintenance of COP, especially in patients presenting a nephrotic syndrome. METHODS: COP was directly assessed with an osmometer in 170 patients (347 samples), and the results compared with calculated COP, using 4 previously published formulas [Brenner 1972, Canaan-Kühl 1993, Landis-Pappenheimer 1963, Navar 1977]. RESULTS: The 4 calculated COP values were strongly correlated with measured COP (range r = 0.88 - 0.96). However, in absolute terms, measured COP differed significantly from each of the 4 calculated mean values of COP (p < 0.001). Fibrinogen exerted per se a weak oncotic effect as measured in vitro. However, fibrinogen was highly related to albumin and presumably reflected the oncotic effect of other liver-derived non-albumin proteins. Inclusion of albumin and fibrinogen in a linear model provided an excellent fit for predicted COP with a highly significant correlation (r = 0.96, p < 0.001) over a wide range of COP values. The predicted equation was: COP(mmHg) = 6.89 x (albumin + fibrinogen) (g/dl) - 5.68. CONCLUSION: None of the 4 most commonly used formulas correctly predicted COP, and direct measurement of COP is still preferable for research studies. The introduction of fibrinogen into the formula estimating COP leads to higher accuracy, and therefore represents a more convenient model for routine evaluation.
Authors:
F Geranton; F Chantrel; M Bouiller; S Muller; I Kolb; B Moulin; T Hannedouche
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical nephrology     Volume:  53     ISSN:  0301-0430     ISO Abbreviation:  Clin. Nephrol.     Publication Date:  2000 Apr 
Date Detail:
Created Date:  2000-07-13     Completed Date:  2000-07-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0364441     Medline TA:  Clin Nephrol     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  269-75     Citation Subset:  IM    
Affiliation:
Service de Néphrologie et Hémodialyse, Hôpitaux Universitaires de Strasbourg, France.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Colloids / metabolism*
Female
Fibrinogen / analysis
Humans
Male
Mathematics
Middle Aged
Nephrotic Syndrome / metabolism*
Osmotic Pressure
Predictive Value of Tests
Serum Albumin
Chemical
Reg. No./Substance:
0/Colloids; 0/Serum Albumin; 9001-32-5/Fibrinogen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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