[en] Introduction: Several clinical settings require an accurate estimation of the physiologically expected extracellular fluid volume (ECFV). We aimed to analyze the performances of existing ECFV-estimating equations and to develop a new equation. Methods: The performances of 11 ECFV-estimating equations were analyzed in 228 healthy kidney donor candidates (Bichat Hospital, Paris, France) who underwent ECFV measurement using the distribution volume of 51Cr-labeled EDTA (51Cr-EDTA). An equation was developed using a penalized linear modeling approach (elastic net regression) and externally (Tenon Hospital, Paris, France, N = 142) validated. Results: Participants from Bichat (mean age 45.2 ± 12.0 years, 43.0% men) and Tenon (47.8 ± 10.3 years, 29.6% men) hospitals had a mean measured ECFV of 15.4 ± 2.8 l and 15.1 ± 2.1 l, respectively. Available ECFV-estimating formulae have highly variable precision and accuracy. The new equation incorporating body weight, height, sex, and age had better precision and accuracy than all other equations in the external validation cohort, with a median bias of −0.20 (95% CI: −0.35 to −0.05) l versus −2.63 (−2.87 to −2.42) l to −0.57 (− 0.83 to −0.40) l and 0.21 (0.12 to 0.43) l to 2.89 (2.65 to 3.11) l, for underestimating and overestimating equations, respectively, an interquartile range for the bias of 0.88 (0.70 to 1.08) l versus 0.91 (0.71 to 1.20) l to 1.93 (1.67 to 2.25) l, and an accuracy within 10% of 90.9% (83.8 to 94.4) versus 88.0% (81.0 to 92.3) to 8.5% (4.2 to 13.4). These results were consistent across subgroups defined by sex, body mass index (BMI), body surface area (BSA), age, and ethnicity. Conclusion: We developed and validated a new equation to estimate the individual reference value of ECFV, which is easily usable in clinical practice. Further validation in cohorts including individuals of extreme age and corpulence remains needed.
Disciplines :
Urology & nephrology
Author, co-author :
Faucon, Anne-Laure ; Clinical Epidemiology Unit, Centre for Research in Epidemiology and Population Health, Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, Villejuif, France ; Université Paris-Saclay, Paris, France ; Department of Physiology, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Bichat, Paris, France
Flamant, Martin; Department of Physiology, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Bichat, Paris, France ; Center for Research on Inflammation, Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM) U1149, Paris, France
DELANAYE, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > > Service de néphrologie ; Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Caremeau, Nîmes, France
Lambert, Oriane; Clinical Epidemiology Unit, Centre for Research in Epidemiology and Population Health, Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, Villejuif, France
Essig, Marie; Université Paris-Saclay, Paris, France ; Department of Nephrology, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Ambroise Paré, Boulogne-Billancourt, France
Peraldi, Marie-Noëlle; Center for Research on Inflammation, Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM) U1149, Paris, France ; Department of Nephrology, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Saint Louis, Paris, France
Tabibzadeh, Nahid; Department of Physiology, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Bichat, Paris, France ; Université de Paris, Unité Mixte de Recherche (UMR) S1138, Cordeliers Research Center, Paris, France
Haymann, Jean-Philippe; Department of Physiology, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Tenon, Paris, France ; Université Pierre et Marie Curie, Paris, France
Stengel, Bénédicte ; Clinical Epidemiology Unit, Centre for Research in Epidemiology and Population Health, Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, Villejuif, France
Geri, Guillaume; Clinical Epidemiology Unit, Centre for Research in Epidemiology and Population Health, Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, Villejuif, France ; Université Paris-Saclay, Paris, France ; Medical Intensive Care Unit, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Ambroise Paré, Boulogne-Billancourt, France
Vidal-Petiot, Emmanuelle; Department of Physiology, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Bichat, Paris, France ; Center for Research on Inflammation, Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM) U1149, Paris, France
Language :
English
Title :
Estimating Extracellular Fluid Volume in Healthy Individuals: Evaluation of Existing Formulae and Development of a New Equation
The authors thank all the individuals for their participation to the study and all the members of the Departments of Physiology from Bichat and Tenon Hospitals, Assistance Publique?H?pitaux de Paris, France. The data that support the findings of this study are available from the corresponding author on reasonable request. ALF, EVP, MF, and GG designed the study. ALF and EVP reviewed the data sets from all participants. ALF and OL performed the statistical analyses. ALF, EVP, MF, and GG interpreted the data. ALF and EVP drafted the manuscript. All authors made critical revision of the manuscript for important intellectual content.
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