Hermida Jesús, Tutor J Carlos
Central Laboratory, Hospital Clinico Universitario, Santiago de Compostela, Spain.
Clin Lab. 2006;52(9-10):483-90.
Determination of the glomerular filtration rate (GFR) is important for the drug dosage adjustment and clinical management of patients. The aim of our study was the comparison of estimated GFR values from serum creatinine (eGFRcreatinine) and cystatin C (eGFRcystatin C) in patients with impaired creatinine production. A total of 564 serum samples from patients with kidney disease (n=179), liver (n=71) and kidney (n=182) transplants, critically ill patients (n=82) and healthy subjects (n=50) were analyzed for serum creatinine and cystatin C. The creatinine production rate (CPR) was significantly lower in the different groups of patients than in the control group (p<0.001). A negative correlation was found between the eGFRcreatinine/eGFRcystatin C ratio and CPR (r= -0.964, p<0.001). For CPR higher than 800 mg/24h both procedures for estimating the GFR classified values higher and lower than 60 mL/min with an acceptable agreement; however, for CPR less than 800 mg/24h the eGFRcreatinine led to false negatives in a high number of cases with eGFRcystatin C <60 mL/min.
测定肾小球滤过率（GFR）对于患者的药物剂量调整和临床管理至关重要。我们研究的目的是比较肌酐生成受损患者中基于血清肌酐估算的GFR值（eGFRcreatinine）和基于胱抑素C估算的GFR值（eGFRcystatin C）。对肾病患者（n = 179）、肝移植患者（n = 71）、肾移植患者（n = 182）、重症患者（n = 82）和健康受试者（n = 50）的总共564份血清样本进行了血清肌酐和胱抑素C分析。不同患者组的肌酐生成率（CPR）显著低于对照组（p < 0.001）。eGFRcreatinine/eGFRcystatin C比值与CPR之间存在负相关（r = -0.964，p < 0.001）。对于CPR高于800 mg/24h的情况，两种估算GFR的方法对高于和低于60 mL/min的值分类具有可接受的一致性；然而，对于CPR低于800 mg/24h的情况，在大量eGFRcystatin C < 60 mL/min的病例中，eGFRcreatinine导致假阴性。
