Glomerular filtration rate what is the rationale and justification of normalizing GFR for body surface area?

Abstract

80 ml/min/1.73 m 2 and 75 ml/min/1.73 m 2 respectively for a 55-year-old prospective kidney donor. The 9.1 ml/min difference between the absolute GFR and the GFR indexed for BSA prompted further consideration of the validity and rationale for indexing GFR to BSA. There are several formulae that estimate BSA from measures of height and weight in the literature and in this man, with height 1.65 m and weight 86 kg, we found that the application of six previously published height–weight formulae to estimate BSA [3–8] gave a range of indexed GFR of 72.0 to 77.9 ml/min/1.73 m 2 . In other words, indexing GFR for BSA in this man reduced the value for GFR by between 9.1 and 15 ml/min depending on which BSA formula was used and greatly influenced the decision about his suitability as a kidney donor. Several authors have questioned the validity of indexing GFR for BSA and the generalizability of the supporting studies from the last century to the increasingly obese population [9–12]. The purpose of this review is to explore the physiological plausibility of using BSA as an appropriate way to index measured GFR, the validity of the methods that