Massey Davis
Department of Pathology, Virginia Commonwealth University, Richmond, Virginia 23298-0662, USA.
J Clin Lab Anal. 2004;18(1):55-60. doi: 10.1002/jcla.10098.
Clinicians recognize and compensate for limitations in estimating the glomerular filtration rate (GFR) using serum creatinine (sCr) measurements by the use of timed collections and mathematical manipulations of sCr. These limitations stem from that fact that sCr is affected by nonrenal influences, including muscle mass and disease state. In addition, sCr may not be sensitive enough to detect minimal declines in GFR in those patient populations in which it is important to recognize early decline. This brief review describes the limitations of sCr, and examines the contribution that sCysC may be able to make in the early recognition of declining renal function. The physiology of CysC is presented, as are the results of clinical investigations that suggest sCysC is in many instances superior to sCr in the recognition of early decline in renal function. Certain exceptions to this are noted.
临床医生认识到使用血清肌酐（sCr）测量值估算肾小球滤过率（GFR）存在局限性，并通过定时收集和对sCr进行数学处理来加以弥补。这些局限性源于sCr受非肾脏因素影响，包括肌肉质量和疾病状态。此外，在那些早期识别肾功能下降很重要的患者群体中，sCr可能不够敏感，无法检测到GFR的微小下降。本简要综述描述了sCr的局限性，并探讨了血清胱抑素C（sCysC）在早期识别肾功能下降方面可能做出的贡献。文中介绍了胱抑素C的生理学，以及临床研究结果，这些结果表明在许多情况下，sCysC在识别肾功能早期下降方面优于sCr。同时也指出了某些例外情况。
